| 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 |