| NPI | 1730584194 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY BRYNE President 469-401-2386 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery |
| Enumeration Date | 2014-10-28 |
| Last Update Date | 2014-10-28 |