| NPI | 1578828893 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICE YVETTE MARSHALL Owner 770-801-0980 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 048274) |
| Additional Taxonomies | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: GA 048274) |
| Enumeration Date | 2012-07-12 |
| Last Update Date | 2012-07-12 |