| NPI | 1013755362 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLESTON CHUA Owner 702-460-6009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2024-07-18 |
| Last Update Date | 2024-07-24 |