| NPI | 1215364047 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT B WINSOR Physician 678-485-1396 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: GA 03158) |
| Enumeration Date | 2013-10-13 |
| Last Update Date | 2013-10-13 |