| NPI | 1922158708 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZAIN KADRI Medical Director 307-867-7300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: WY 7569A) |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2020-08-22 |