| NPI | 1164589065 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ENRIQUE J FERNANDEZ President 912-261-0044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: GA #036152) |
| Additional Taxonomies | 174400000X Specialist (Licence: GA 036152) |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2011-04-22 |