| NPI | 1659709046 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL LESLIE WIENS SVP/Operations Cpn 704-355-0648 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 2086S0122X Surgery Plastic and Reconstructive Surgery |
| Enumeration Date | 2013-10-22 |
| Last Update Date | 2014-02-25 |