| NPI | 1326391848 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMIE MICHELLE MOENSTER Primary Shareholder 636-541-1584 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: AZ 006018) |
| Enumeration Date | 2012-10-22 |
| Last Update Date | 2023-07-26 |