NPI | 1417142464 |
---|---|
Entity Type | Organization |
Authorized Contact | THOMAS L BASS Physician 954-966-8559 |
Organization Subpart ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: FL ME66691) |
Additional Taxonomies | 208600000X Surgery (Licence: FL ME89620) |
208600000X Surgery (Licence: FL OS9744) | |
Enumeration Date | 2007-09-12 |
Last Update Date | 2012-03-02 |