| NPI | 1467878181 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY MILLER Credentialing Specialist 785-505-2988 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: KS 0429112) |
| Enumeration Date | 2014-03-06 |
| Last Update Date | 2014-03-19 |