| NPI | 1043650872 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN COUSINS Owner 786-637-3332 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery |
| Additional Taxonomies | 207XS0106X Orthopaedic Surgery Hand Surgery (Licence: FL ME115543) |
| Enumeration Date | 2013-06-25 |
| Last Update Date | 2019-12-10 |