| NPI | 1134164452 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MUKESH AGARWAL Secretary/Treasurer 912-338-0065 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 039994) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 048327) |
| Enumeration Date | 2006-06-19 |
| Last Update Date | 2009-10-15 |