| NPI | 1689857096 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDOLPH BAKER CAPONE Owner 410-848-4123 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: MD D0060483) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: MD D0060483) |
| Enumeration Date | 2007-12-07 |
| Last Update Date | 2007-12-07 |