| NPI | 1518655943 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT REID NOTTINGHAM Founder/Licensed Surgical Assist 757-439-0033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Enumeration Date | 2023-04-25 |
| Last Update Date | 2023-04-27 |