| NPI | 1811089675 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIE LAWRENCE Administrator 314-523-5303 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery |
| Additional Taxonomies | 207Y00000X Otolaryngology |
| 207YS0123X Otolaryngology, Facial Plastic Surgery | |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2009-01-13 |