| NPI | 1891104188 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDGAR DOMENECH FAGUNDO Owner 787-290-3333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: PR 13247) |
| Enumeration Date | 2014-08-12 |
| Last Update Date | 2014-08-12 |