| NPI | 1568025419 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRISHA KHANNA Owner 352-565-7633 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery |
| Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery |
| Enumeration Date | 2019-04-17 |
| Last Update Date | 2022-11-16 |