| NPI | 1962762708 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REUBEN KRISTIAN ELLIS Owner/Physician 404-877-8115 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: GA 055819) |
| Enumeration Date | 2012-05-28 |
| Last Update Date | 2020-11-19 |