| NPI | 1104088905 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTY AQUINO Director Of Provider Enrollment 470-271-3427 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207RC0000X Internal Medicine, Cardiovascular Disease | |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2021-08-10 |