| NPI | 1013240159 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LADAWN MICHELLE TALBOTT Owner 775-348-4790 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery |
| Additional Taxonomies | 2086S0122X Surgery Plastic and Reconstructive Surgery |
| Enumeration Date | 2009-09-08 |
| Last Update Date | 2010-04-08 |