| NPI | 1063549178 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA GORMAN Vice Pres Office Manager 601-373-3730 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: MS 08261) |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2008-04-20 |