| NPI | 1427449081 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN TOBIAS GRAY Chief Executive Officer 954-292-8657 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2015-02-18 |
| Last Update Date | 2015-02-18 |