| NPI | 1104683200 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENIECE NICOLE JOHNSON Owner 404-429-2226 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RB0002X Internal Medicine, Bariatric Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2024-03-05 |
| Last Update Date | 2024-03-05 |