NPI | 1629344833 |
---|---|
Entity Type | Organization |
Authorized Contact | JEFFERY KEITH KRUEGER President 214-739-5760 |
Organization Subpart ? | No |
Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: TX K6769) |
Enumeration Date | 2012-04-02 |
Last Update Date | 2012-04-02 |