| NPI | 1063647154 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM NOBLE GRAHAM Owner 605-996-8386 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: SD 4248) |
| Enumeration Date | 2009-05-19 |
| Last Update Date | 2009-05-19 |