| 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 |