| NPI | 1184130627 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTY AQUINO Director Of Provider Enrollment 470-271-3427 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology |
| 208600000X Surgery | |
| Enumeration Date | 2017-12-20 |
| Last Update Date | 2021-08-11 |