| NPI | 1538415369 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOUIS MAZZELLA Sole Member 404-805-2290 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208600000X Surgery |
| Enumeration Date | 2012-07-30 |
| Last Update Date | 2014-09-19 |