| NPI | 1639812944 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTINA LARSEN Owner 404-702-8761 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2022-04-14 |
| Last Update Date | 2022-04-14 |