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 |