NPI | 1962070334 |
---|---|
Entity Type | Organization |
Authorized Contact | DANIEL E VERBIST Member/Manager 270-709-1984 |
Organization Subpart ? | No |
Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery |
Enumeration Date | 2021-06-14 |
Last Update Date | 2022-04-06 |