| NPI | 1730366394 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON CHARLES STANFORD Owner Physician Assistant 301-528-0868 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MD C0002208) |
| Enumeration Date | 2008-01-25 |
| Last Update Date | 2008-01-25 |