Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 46248 | AZ |
NPI | 1619123528 |
---|---|
Provider Name | Brian G Lee |
First Address | Scottsdale, AZ 85251-6443 |
Second Address | Scottsdale, AZ 85251-6443 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2008 |
Last Update Date | 17/10/2012 |