| NPI | 1659254969 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUES EMILE BUSSIERE Surgical Assistant 301-257-6191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Enumeration Date | 2025-07-26 |
| Last Update Date | 2025-08-13 |