| NPI | 1205939691 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE M KANDRACH Physician Assistant 404-778-5040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: GA 000262) |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2020-08-22 |