| NPI | 1003143942 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT LEE YOUNGBLOOD Medical Doctor 801-571-4007 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: UT 150842-1205) |
| Enumeration Date | 2009-11-13 |
| Last Update Date | 2009-11-13 |