| NPI | 1750833117 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AAYESHA MUMTAZ KAHN Owner 314-898-8368 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology |
| Additional Taxonomies | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck |
| Enumeration Date | 2016-11-01 |
| Last Update Date | 2016-11-01 |