| NPI | 1093308918 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIVIAN ADU-ABOAGYE Administrator 470-331-9468 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family |
| Additional Taxonomies | 261QP2300X Clinic/Center Primary Care |
| Enumeration Date | 2021-02-12 |
| Last Update Date | 2021-05-24 |