| NPI | 1427416650 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AJANI NUGENT Authroized Representative 404-550-9857 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology |
| Additional Taxonomies | 208200000X Plastic Surgery |
| Enumeration Date | 2016-02-02 |
| Last Update Date | 2016-02-02 |