NPI | 1225840069 |
---|---|
Entity Type | Organization |
Authorized Contact | ERIC J ROBERTS President 678-910-8116 |
Organization Subpart ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
Additional Taxonomies | 213EP1101X Podiatrist, Primary Podiatric Medicine |
Enumeration Date | 2025-01-20 |
Last Update Date | 2025-01-20 |