| NPI | 1619256385 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID GREENE Owner 239-216-6542 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: FL ME78059) |
| Enumeration Date | 2011-08-11 |
| Last Update Date | 2011-11-17 |