Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | 033853 | GA |
N | 208200000X | Surgeon | 033853 | GA |
N | 208600000X | Surgeon | 033853 | GA |
NPI | 1851341614 |
---|---|
Provider Name | Christian Peter Larsen |
First Address | Atlanta, GA 30322 |
Second Address | Atlanta, GA 30322 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E88103 | (02) |