| NPI | 1740767102 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN WINSLOW GORDON Managing Member 702-242-6900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: NV 7986) |
| Enumeration Date | 2018-07-27 |
| Last Update Date | 2018-07-27 |