| NPI | 1477608198 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MITZE S. SEGERS Billing Supervisor 336-886-1667 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: NC 9401312) |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2020-08-22 |