| NPI | 1821330002 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARSHA RENEE JESPERSEN Owner 703-893-1111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: VA 0101233956) |
| Enumeration Date | 2013-03-26 |
| Last Update Date | 2013-03-26 |