| NPI | 1851491021 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA DLUBALA Billing Manager 757-423-2166 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: VA 0101035886) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2012-10-02 |