| NPI | 1699959197 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON HIRSBRUNNER Chief Executive Officer 863-680-7007 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery |
| Additional Taxonomies | 208600000X Surgery |
| Enumeration Date | 2007-12-20 |
| Last Update Date | 2024-03-01 |