| NPI | 1801289541 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHANTEL LEE Physician Assistant 770-865-9023 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: GA 005514) |
| Enumeration Date | 2015-03-05 |
| Last Update Date | 2015-03-05 |