| NPI | 1356317853 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC J WYBLE Owner Medical Doctor 228-865-7299 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: MS 12046) |
| Enumeration Date | 2006-02-24 |
| Last Update Date | 2007-07-10 |