| NPI | 1821163577 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NEIL ANTHONY PERSAUD Owner 678-838-3903 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207YX0905X Otolaryngology Otolaryngology/Facial Plastic Surgery |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2020-08-22 |