| NPI | 1578314738 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GABRIELLA ALEXA URSICK Managing Member 201-919-3440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Enumeration Date | 2024-03-27 |
| Last Update Date | 2024-03-27 |