| NPI | 1154524619 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHYLAJA RRABHAKAR Physician 229-888-7332 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 042699) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: GA 042394) |
| 208000000X Pediatrics (Licence: GA 042394) | |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2011-05-02 |