NPI | 1629845680 |
---|---|
Entity Type | Organization |
Authorized Contact | KRISTY AYCINENA Surgical First Assistant 678-858-1980 |
Organization Subpart ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
Enumeration Date | 2023-12-08 |
Last Update Date | 2024-05-15 |