| NPI | 1457718207 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AJANI G NUGENT Authroized Representative 404-550-9857 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: FL ME125166) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: FL ME125166) |
| Enumeration Date | 2016-01-25 |
| Last Update Date | 2016-01-25 |