NPI | 1174898597 |
---|---|
Entity Type | Organization |
Authorized Contact | WANDA LYNN DITTHARDT Office Manager 954-964-4113 |
Organization Subpart ? | No |
Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery |
Enumeration Date | 2012-03-19 |
Last Update Date | 2012-07-18 |