NPI age
18 years
Enumerated 2007-11-06
Across 563 active urology providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 048133 | LICENCE NUMBER |
| 05 (GA) | 00856193A |
Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.
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