| NPI | 1447484159 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER JOHN KOVANDA Sole Member 763-416-0676 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: MN 41657) |
| Enumeration Date | 2009-05-08 |
| Last Update Date | 2019-12-10 |