| NPI | 1457969115 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PABLO ANDRES PRICHARD Owner 480-625-0003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery |
| Enumeration Date | 2020-07-20 |
| Last Update Date | 2020-07-20 |