| NPI | 1750371571 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY M. BUNCKE Owner 415-565-6136 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: CA 35001) |
| Enumeration Date | 2005-10-24 |
| Last Update Date | 2011-05-03 |