| NPI | 1164499869 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEAN CHRISTIAN Practice Administrator 404-601-7290 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: GA Not applicable) |
| Enumeration Date | 2006-03-02 |
| Last Update Date | 2020-08-22 |