| NPI | 1457864522 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN JIMENEZ Hair Loss Specialist 239-271-5056 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1744P3200X Specialist, Prosthetics Case Management (Licence: FL 1213036) |
| Enumeration Date | 2017-11-13 |
| Last Update Date | 2017-11-13 |