| NPI | 1174998702 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES P VIRDEN CEO/Founder 775-348-9798 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: NV 7420) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NV PA1641) |
| Enumeration Date | 2015-12-08 |
| Last Update Date | 2016-01-07 |