| NPI | 1477184562 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SIVA ELANGOVAN Member 708-689-4770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery |
| Enumeration Date | 2020-01-28 |
| Last Update Date | 2021-08-09 |