| NPI | 1063464717 |
|---|---|
| Other Name | PLLC |
| Entity Type | Organization |
| Authorized Contact | DONALD JOSEPH CAPUANO Director 515-225-0680 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: NY 1052901) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2008-04-29 |