| NPI | 1053565580 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHEREEN TIMANI Owner 770-771-6591 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: GA 061526) |
| Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology (Licence: GA 061526) |
| 207Q00000X Family Medicine (Licence: GA 061566) | |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: GA 061566) | |
| Enumeration Date | 2008-11-11 |
| Last Update Date | 2010-10-05 |