| NPI | 1588787220 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM BRUCE HARRIS Owner 251-368-9826 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: AL 9132) |
| Additional Taxonomies | 208600000X Surgery |
| 2086X0206X Surgery, Surgical Oncology | |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2023-02-09 |