| NPI | 1326202193 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | W ALEXANDRA DA SOUZA President 912-510-9100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: GA 042556) |
| Enumeration Date | 2008-07-10 |
| Last Update Date | 2008-09-10 |