| NPI | 1306308382 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAE KIM Authorized Member 347-551-1113 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology Facial Plastic Surgery |
| Additional Taxonomies | 261QM2500X Clinic/Center Medical Specialty |
| Enumeration Date | 2019-04-01 |
| Last Update Date | 2019-06-11 |