NPI | 1861645178 |
---|---|
Entity Type | Organization |
Authorized Contact | GREGORY MICHAEL BAZELL Owner/Director 847-382-4160 |
Organization Subpart ? | No |
Primary Taxonomy | 208200000X Plastic Surgery (Licence: IL 036103581) |
Enumeration Date | 2008-10-30 |
Last Update Date | 2008-10-30 |