| NPI | 1780923110 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY W SLATER Certified Surgical First Assist 727-204-7315 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: FL 129713) |
| Enumeration Date | 2013-02-05 |
| Last Update Date | 2024-05-21 |