| NPI | 1194180638 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRIS J AUGUSTIAN CEO / Chief Executive Officer 920-490-9046 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2015-12-29 |
| Last Update Date | 2022-04-13 |