| NPI | 1386204584 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTHA SANCHEZ Billing Team Lead 346-571-8487 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery |
| Additional Taxonomies | 207Y00000X Otolaryngology |
| 207YS0123X Otolaryngology, Facial Plastic Surgery | |
| 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck | |
| 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck | |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery | |
| Enumeration Date | 2019-06-19 |
| Last Update Date | 2020-08-27 |