| NPI | 1366759938 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS T. LE Medical Director 877-917-3223 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: MD D0061873) |
| Enumeration Date | 2010-09-02 |
| Last Update Date | 2012-01-29 |