| NPI | 1639878119 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACEY RENAE JOYNER Certified Surgical First Assist 601-604-2858 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical |
| Enumeration Date | 2023-02-23 |
| Last Update Date | 2023-03-03 |