| NPI | 1578041208 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STORM ESTELLE Owner/Ambr 954-854-0628 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9102746) |
| Enumeration Date | 2018-08-03 |
| Last Update Date | 2020-04-02 |