| NPI | 1205134673 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SALLU JABATI Medical Director 678-559-4526 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: GA 058527) |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2011-03-08 |
| Last Update Date | 2011-03-08 |