| NPI | 1508541632 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYLER S OKLAND Sole Member 720-583-5974 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery |
| Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery |
| 207Y00000X Otolaryngology | |
| 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery | |
| Enumeration Date | 2023-06-16 |
| Last Update Date | 2023-08-14 |