| NPI | 1356699805 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FARAH KHAN Owner 813-362-1629 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: TX P0744) |
| Enumeration Date | 2012-08-15 |
| Last Update Date | 2012-08-15 |