NPI | 1275707424 |
---|---|
Entity Type | Organization |
Authorized Contact | BRUCE V LATTYAK Owner 530-477-1199 |
Organization Subpart ? | No |
Primary Taxonomy | 208200000X Plastic Surgery (Licence: CA A62583) |
Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA A62583) |
Enumeration Date | 2008-04-18 |
Last Update Date | 2019-08-29 |