| NPI | 1528206836 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYRONE W ROGERS Owner 707-338-5520 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: GA 2838) |
| Enumeration Date | 2009-01-23 |
| Last Update Date | 2009-01-26 |