NPI | 1619213428 |
---|---|
Entity Type | Organization |
Authorized Contact | JORDAN DESCHAMPS-BRALY Owner 415-624-3922 |
Organization Subpart ? | No |
Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: CA A-121399) |
Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: CA A121399) |
261QM2500X Clinic/Center, Medical Specialty | |
Enumeration Date | 2012-12-26 |
Last Update Date | 2019-12-20 |