| NPI | 1316276769 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADFORD SCOTT BOOTSTAYLOR Director 678-789-1123 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: GA 041733) |
| Enumeration Date | 2009-12-14 |
| Last Update Date | 2009-12-14 |