| NPI | 1144989401 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICIA BROSIUS Administrator 818-206-2539 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck |
| Enumeration Date | 2021-12-14 |
| Last Update Date | 2022-08-25 |