| NPI | 1861641680 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL A DORSEY CEO Providence Health 913-596-4000 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: KS 0432718) |
| Enumeration Date | 2008-09-17 |
| Last Update Date | 2008-10-21 |