| NPI | 1316268386 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES ROBERT PETTIT President 707-843-3999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery |
| Enumeration Date | 2010-06-14 |
| Last Update Date | 2015-08-14 |