NPI | 1952333411 |
---|---|
Entity Type | Organization |
Authorized Contact | RAVINDER K KURL Doctor 678-289-0188 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: GA 045274) |
Enumeration Date | 2006-07-07 |
Last Update Date | 2020-08-22 |