NPI | 1417220609 |
---|---|
Entity Type | Organization |
Authorized Contact | TOMMY HAMMONDS Chief Executive Officer 1619-985-7698 |
Organization Subpart ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CA G69685) |
Enumeration Date | 2012-02-17 |
Last Update Date | 2012-02-17 |