| NPI | 1801284518 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARLENE L. BLAISE Owner 678-762-0910 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: GA 48028) |
| Enumeration Date | 2015-01-05 |
| Last Update Date | 2023-02-09 |