| NPI | 1710058375 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE J. KORKOS Plastic Surgeon 262-970-5600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: WI 13791) |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2020-08-22 |