| NPI | 1598119547 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRIS AUGUSTIAN CEO 920-405-5382 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 208200000X Plastic Surgery |
| Enumeration Date | 2016-04-15 |
| Last Update Date | 2022-04-20 |