| NPI | 1952387516 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WALLACE P BERKOWITZ President Owner 314-647-8895 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: IL 036041982) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MO R4234) |
| Enumeration Date | 2005-12-15 |
| Last Update Date | 2008-04-20 |