| NPI | 1881666725 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARA CACERES-CANTU President 678-867-9689 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: GA 49485) |
| Enumeration Date | 2006-02-04 |
| Last Update Date | 2020-08-22 |