| NPI | 1821130071 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VINCENT MICHAEL NICOLAIS Owner 706-561-4992 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2013-10-08 |