| NPI | 1063783660 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAIGE SMITH Credentialing Manager 301-509-4091 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: MD D0037204) |
| Enumeration Date | 2012-01-13 |
| Last Update Date | 2021-02-12 |