| NPI | 1659515237 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER JONATHAN JENSEN Owner 907-457-5277 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: NY 248277) |
| Enumeration Date | 2009-04-27 |
| Last Update Date | 2009-04-27 |