| NPI | 1225746894 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KINGSLEY IWUDIBIA Owner 470-377-6400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2022-11-11 |
| Last Update Date | 2023-07-12 |