| NPI | 1043729569 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENEE GASGARTH Cea/Director 404-617-9645 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery |
| Enumeration Date | 2017-09-27 |
| Last Update Date | 2022-07-21 |