| NPI | 1760656607 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDITH MORIN GURLEY Surgeon/Member 636-812-4300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: MO 114740) |
| Enumeration Date | 2008-04-22 |
| Last Update Date | 2008-04-22 |