| NPI | 1013927946 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINA RIOS Credentialing Specialist 706-854-2558 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: GA 056877) |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2020-08-22 |