| NPI | 1023461811 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MI KIM Owner 404-291-6473 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: GA POD001300) |
| Enumeration Date | 2016-07-18 |
| Last Update Date | 2016-07-18 |