| NPI | 1962872218 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL FENDERSON Certified Surgical Assistant 678-799-2498 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant |
| Enumeration Date | 2015-09-30 |
| Last Update Date | 2015-09-30 |