| NPI | 1609102706 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KHASHAYAR DEHGHAN Member/Owner 618-531-9518 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: WA MD00047758) |
| Enumeration Date | 2009-10-23 |
| Last Update Date | 2009-10-23 |