| NPI | 1790066967 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN S. BRUNO President 239-936-2522 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: FL ME13183) |
| Enumeration Date | 2011-09-01 |
| Last Update Date | 2011-09-01 |