| NPI | 1730106725 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT HAGAN Managing Employee/Owner 314-434-7784 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: MO 2002014802) |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2014-08-12 |