| NPI | 1740547595 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN KULBERSH Owner 843-906-4761 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: NC 2010-0220) |
| Enumeration Date | 2012-04-18 |
| Last Update Date | 2012-04-18 |