| NPI | 1962734814 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES GARDINER Owner 240-912-2206 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MD C00815) |
| Enumeration Date | 2010-02-03 |
| Last Update Date | 2014-08-26 |