| NPI | 1376992909 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM H LARSEN Director Of Credentialing 770-874-5400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207PT0002X Emergency Medicine Medical Toxicology |
| Additional Taxonomies | 207PE0005X Emergency Medicine Undersea and Hyperbaric Medicine |
| 2083P0011X Preventive Medicine Undersea and Hyperbaric Medicine | |
| 2083T0002X Preventive Medicine Medical Toxicology | |
| Enumeration Date | 2016-06-04 |
| Last Update Date | 2020-02-05 |