| NPI | 1639232291 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GOPAL NAIQUE PANVELKAR Physician 706-660-1177 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: GA GA-037307) |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2010-04-02 |