| NPI | 1194331439 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAWA SITOU Fnp 770-629-1917 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 261Q00000X Clinic/Center | |
| Enumeration Date | 2020-09-22 |
| Last Update Date | 2021-05-17 |