Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | 35093806 | OH |
NPI | 1518169978 |
---|---|
Provider Name | Aaron I Brescia |
First Address | Canton, OH 44718-2599 |
Second Address | Canton, OH 44718-2599 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2007 |
Last Update Date | 24/06/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2954692 | (05) | OH |