| NPI | 1639843113 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARL TRUESDALE Owner 424-210-5498 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck |
| Enumeration Date | 2021-08-06 |
| Last Update Date | 2021-08-06 |