NPI | 1235663261 |
---|---|
Entity Type | Organization |
Authorized Contact | MILLICENT OVERLEY ROVELO Owner 310-403-0562 |
Organization Subpart ? | No |
Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: CA A130080) |
Enumeration Date | 2017-04-17 |
Last Update Date | 2018-03-17 |