| NPI | 1154605590 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KHALID JALIL Physician/Pres Corporation 770-389-9642 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: GA 039829) |
| Enumeration Date | 2011-10-04 |
| Last Update Date | 2011-10-04 |