| NPI | 1609175421 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDAL RUDDERMAN President 678-566-7200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: GA 024863) |
| Enumeration Date | 2011-03-18 |
| Last Update Date | 2015-06-22 |