| NPI | 1750435749 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HONORIO ROWELL BULOS Owner Physician 706-216-2771 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: GA 48029) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2013-05-08 |