| NPI | 1568793255 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GAIL S LAMB Business Office Manager 941-926-0969 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9102238) |
| Enumeration Date | 2010-01-20 |
| Last Update Date | 2010-01-20 |