| NPI | 1538665518 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADLERE MICHEL ETIENNE Certified Surgical Assistant 757-606-4702 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Enumeration Date | 2018-03-30 |
| Last Update Date | 2018-03-30 |