| NPI | 1871666446 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY MICHAEL PETRUS President 501-758-9800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: AR C7318) |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2011-01-28 |