| NPI | 1235395179 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHABNAM SHAHABADI Co Manager 703-645-0077 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: VA 0101243338) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: VA 0101243725) |
| Enumeration Date | 2008-07-30 |
| Last Update Date | 2020-11-23 |