| NPI | 1689965956 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILIP RODRIGUEZ President 306-858-3096 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: FL 38936500128250) |
| Enumeration Date | 2011-04-21 |
| Last Update Date | 2011-04-21 |