| NPI | 1073772919 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOBY THOMAS Vice President Managed Care 404-785-7914 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics |
| Additional Taxonomies | 208000000X Pediatrics |
| Enumeration Date | 2008-06-05 |
| Last Update Date | 2008-06-05 |