| NPI | 1841914090 |
|---|---|
| Other Name | GEORGIA |
| Entity Type | Organization |
| Authorized Contact | MICHAEL HUY LE Chief Medical Officer 657-400-5180 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Enumeration Date | 2022-09-30 |
| Last Update Date | 2022-09-30 |