| NPI | 1154706075 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAKSHMAN K DINAVAHI Chief Medical Officer 678-390-0120 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: GA 07088) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 07088) |
| 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: GA 07088) | |
| Enumeration Date | 2015-07-21 |
| Last Update Date | 2015-07-22 |