| NPI | 1811365703 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN G LEE Owner 480-994-0308 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: AZ 46248) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: AZ 8027) |
| 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: AZ 8027) | |
| Enumeration Date | 2015-09-09 |
| Last Update Date | 2015-09-09 |