| NPI | 1396228995 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VINCENT J PERROTTA Owner/President 410-546-0464 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 2086S0122X Surgery Plastic and Reconstructive Surgery |
| Enumeration Date | 2018-09-10 |
| Last Update Date | 2021-08-02 |