| NPI | 1043442080 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAM Q PENG Director 770-820-3855 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: GA 057232) |
| Enumeration Date | 2009-08-10 |
| Last Update Date | 2009-08-10 |