| NPI | 1689631335 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREG ROY CABRERA President/Owner 770-664-0088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 174400000X Specialist (Licence: GA 042025) |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2022-08-25 |