| NPI | 1285632158 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFF H CRAWFORD Assistant Administrator 573-882-7767 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MO 000011109) |
| Enumeration Date | 2005-07-13 |
| Last Update Date | 2007-09-13 |