| NPI | 1679010011 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LONNIE W BUNN Business Manager 919-706-4900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: NC 2011000555) |
| Additional Taxonomies | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: NC 200900778) |
| Enumeration Date | 2017-01-24 |
| Last Update Date | 2017-01-24 |