| NPI | 1013665488 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KALILIAH WILSON Credentialing Specialist 404-287-3212 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology |
| Enumeration Date | 2022-03-15 |
| Last Update Date | 2023-10-02 |