| NPI | 1124107867 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LIRIO ESCARRILLA PALMOS Provider/Owner 706-322-5526 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: GA 055161) |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2008-04-17 |