| NPI | 1003336819 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL E. BURK Physician 314-821-5002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207YX0905X Otolaryngology Otolaryngology/Facial Plastic Surgery (Licence: MO R6G71) |
| Additional Taxonomies | 207YX0602X Otolaryngology Otolaryngic Allergy (Licence: MO R6G71) |
| Enumeration Date | 2017-06-22 |
| Last Update Date | 2019-08-13 |