| NPI | 1932801776 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSE FALK Member 702-660-5574 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery |
| Additional Taxonomies | 207Y00000X Otolaryngology |
| Enumeration Date | 2023-03-17 |
| Last Update Date | 2023-03-17 |