| NPI | 1356542997 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VINCENT MICHAEL NICOLAIS Executive Member 706-221-4836 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: GA 34676) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CT 17941) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NY 131631) | |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2008-01-08 |