| NPI | 1902218837 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JORDAN DESCHAMPS-BRALY Owner 415-524-3922 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: CA A121399) |
| Enumeration Date | 2014-05-27 |
| Last Update Date | 2015-07-17 |