NPI | 1700201407 |
---|---|
Entity Type | Organization |
Authorized Contact | DENNIS PATRICK PORTO Owner 515-222-0677 |
Organization Subpart ? | No |
Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: IA 27404) |
Enumeration Date | 2014-03-04 |
Last Update Date | 2014-03-04 |