| NPI | 1942723028 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CSHANYSE AVRIL ALLEN CEO 706-705-2033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics Adolescent Medicine |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN146812) |
| 163W00000X Registered Nurse | |
| Enumeration Date | 2017-07-20 |
| Last Update Date | 2021-08-26 |