| NPI | 1114725850 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA REPAC CFO 301-790-9351 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery |
| Additional Taxonomies | 208600000X Surgery |
| 208D00000X General Practice | |
| Enumeration Date | 2025-03-07 |
| Last Update Date | 2025-03-07 |