| NPI | 1114744703 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN MARIE VAUGHN Authorized Official 404-450-4684 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2024-09-24 |
| Last Update Date | 2024-09-24 |