| NPI | 1477519544 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN DAVID HOLCOMB Manager 941-365-8679 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: FL ME80017) |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2012-09-17 |