| NPI | 1427362995 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DERRELL NESMITH Certified Surgical Assistant 404-932-0637 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: GA 2840) |
| Enumeration Date | 2010-07-27 |
| Last Update Date | 2010-07-27 |