NPI | 1528456548 |
---|---|
Entity Type | Organization |
Authorized Contact | JOHN TOBIAS GRAY CEO 954-791-6146 |
Organization Subpart ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA3649) |
Enumeration Date | 2014-12-29 |
Last Update Date | 2020-06-23 |