| NPI | 1255828398 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARLENE LABOSTRIE Manager 404-490-0304 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: LA AP09804) |
| Enumeration Date | 2018-04-14 |
| Last Update Date | 2018-04-14 |