| NPI | 1750778932 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSE-MARY MBIBONG-MABO Organizer 770-284-1616 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: GA POD001234) |
| Enumeration Date | 2015-04-24 |
| Last Update Date | 2024-03-07 |