| NPI | 1134564073 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LETICIA IBARRA PELTZER Owner/Provider 276-698-8099 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: VA 0101238767) |
| Enumeration Date | 2013-05-06 |
| Last Update Date | 2014-11-20 |