| NPI | 1639297401 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GWENDOLYN A DELANEY Managing Member 678-990-2501 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics Adolescent Medicine (Licence: GA 049380) |
| Additional Taxonomies | 2080A0000X Pediatrics Adolescent Medicine (Licence: GA 051519) |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2020-01-14 |