| NPI | 1386392264 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIM ORTLIP CFO 804-513-6252 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery |
| Additional Taxonomies | 207Y00000X Otolaryngology |
| 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck | |
| 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery | |
| Enumeration Date | 2022-03-10 |
| Last Update Date | 2022-03-10 |