| NPI | 1194144493 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID WASTSON RODWELL Owner 843-882-7181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: SC TL36529) |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2014-04-15 |