| NPI | 1992569420 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS MCEWAN Owner 573-673-8488 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery |
| Additional Taxonomies | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery |
| Enumeration Date | 2024-02-06 |
| Last Update Date | 2024-02-06 |