| NPI | 1912956046 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTY AQUINO Director Of Provider Enrollment 470-895-0214 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2006-05-08 |
| Last Update Date | 2023-04-11 |