| NPI | 1780343848 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARGARET RASKOWSKY Adminstration 888-491-1210 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0102X Surgery Surgical Critical Care |
| Additional Taxonomies | 208600000X Surgery |
| 2086S0122X Surgery Plastic and Reconstructive Surgery | |
| Enumeration Date | 2021-12-15 |
| Last Update Date | 2024-02-07 |