| NPI | 1922482066 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTIAN WATKINS Practice Director 703-544-8971 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: VA 0101258156) |
| Enumeration Date | 2015-07-18 |
| Last Update Date | 2015-08-27 |