| NPI | 1013219492 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA A DICICCO Office Manager 4016-320-4702 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: RI RI 12444) |
| Enumeration Date | 2010-11-17 |
| Last Update Date | 2010-11-17 |