Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | 006111 | AZ |
NPI | 1982961850 |
---|---|
Provider Name | Bryan David Friedman |
First Address | Scottsdale, AZ 85251-2106 |
Second Address | Scottsdale, AZ 85251-2106 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2012 |
Last Update Date | 14/08/2015 |