| NPI | 1134329477 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VALORIE PECK Office Manager 219-836-8136 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: IN 01039206A) |
| Enumeration Date | 2007-07-24 |
| Last Update Date | 2009-11-23 |