| NPI | 1932432093 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW GIBSON Owner 904-998-0997 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA2492) |
| Enumeration Date | 2009-09-08 |
| Last Update Date | 2009-09-08 |