| NPI | 1659620110 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PEG S GILBERTSON Practice Manager 701-499-4807 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: ND PT 12481) |
| Enumeration Date | 2012-08-30 |
| Last Update Date | 2012-09-27 |