| NPI | 1578023321 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | APRYL ESPINOZA-WADE Health Information Mgr 678-964-5234 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Enumeration Date | 2019-03-20 |
| Last Update Date | 2023-11-27 |