| NPI | 1407490105 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN BURK Designated Official 314-541-6838 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery |
| Enumeration Date | 2019-11-05 |
| Last Update Date | 2022-10-03 |