| NPI | 1073844205 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAILESH SUSHIL KOTHARI CEO 770-938-2625 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 024649) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: GA chiro08446) |
| 207R00000X Internal Medicine (Licence: GA 044228) | |
| Enumeration Date | 2010-01-28 |
| Last Update Date | 2011-02-07 |