| NPI | 1174943377 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUNNY PARK CEO 267-456-5066 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: CA a114258) |
| Enumeration Date | 2014-04-26 |
| Last Update Date | 2015-01-09 |