| NPI | 1992133466 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXANDRE DESOUZA President 304-422-2940 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WV 18860) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: WV 18860) |
| Enumeration Date | 2013-10-21 |
| Last Update Date | 2013-10-21 |