| NPI | 1508019415 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARYN RAE Director 843-876-1344 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery | |
| Enumeration Date | 2008-10-23 |
| Last Update Date | 2008-11-21 |