| NPI | 1386523215 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEV ANAND MANISUNDARAM Authorized Official 601-387-9005 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery |
| Enumeration Date | 2025-08-27 |
| Last Update Date | 2025-08-27 |