| NPI | 1891475752 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM LARSEN Director Of Credentialing 770-874-5400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2023-07-24 |
| Last Update Date | 2026-08-13 |