NPI age
19 years
Enumerated 2006-06-06
Across 450 active otolaryngology providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 00444034A | |
| 01 (GA) | 22148 | STATE LICENSE |
Solo or small practice. No other active providers share this practice address in NPPES.
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