| NPI | 1306002308 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE DYBAS Office Manager 818-905-1198 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207YP0228X Otolaryngology Pediatric Otolaryngology (Licence: CA G31963) |
| Enumeration Date | 2008-07-30 |
| Last Update Date | 2008-07-30 |