| NPI | 1568633568 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID PARKER BOGUE Sole Proprietor 561-886-1000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: FL ME100042) |
| Enumeration Date | 2008-03-18 |
| Last Update Date | 2009-01-08 |