| NPI | 1023259454 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH G WHITAKER Sole Owner 678-392-6808 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: GA 41239) |
| Enumeration Date | 2009-03-15 |
| Last Update Date | 2009-03-15 |