| NPI | 1962793505 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM TROY AUSTIN Managing Member 561-310-1668 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: GA 59595) |
| Enumeration Date | 2011-05-01 |
| Last Update Date | 2011-05-01 |