| NPI | 1518629427 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY DANIEL Owner 478-272-3525 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease |
| Additional Taxonomies | 246XC2903X Spec/Tech, Cardiovascular, Vascular Specialist |
| Enumeration Date | 2021-10-07 |
| Last Update Date | 2021-10-07 |