| NPI | 1124434428 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | M'LISS E. HOGAN Manager/Agent 985-898-1106 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: LA MD.203311) |
| Enumeration Date | 2014-07-08 |
| Last Update Date | 2014-07-08 |