| NPI | 1245406438 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NINO RENZO FORNASINI Physician/Owner 770-622-3948 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: GA 048628) |
| Additional Taxonomies | 208000000X Pediatrics |
| Enumeration Date | 2008-05-07 |
| Last Update Date | 2021-08-09 |