| NPI | 1235612862 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SYLVIA RICHARDSON Office Manager 678-344-2450 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 208200000X Plastic Surgery |
| Enumeration Date | 2018-09-10 |
| Last Update Date | 2018-09-10 |