| NPI | 1336614866 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MILAN PATEL Credentialing Manager 678-381-2020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2018-10-11 |
| Last Update Date | 2023-04-05 |