| NPI | 1255690475 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADESUPO OSHIYOYE Treasurer 770-894-3167 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: GA 51736) |
| Enumeration Date | 2012-05-08 |
| Last Update Date | 2012-05-08 |