| NPI | 1750760898 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NEIL SHAILESH GHODADRA Medical Director 678-596-1344 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CA A116163) |
| Enumeration Date | 2015-05-21 |
| Last Update Date | 2015-05-21 |