Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 64169 | GA |
NPI | 1235316639 |
---|---|
Provider Name | Iris Iliana Krishna |
First Address | Atlanta, GA 30308-2208 |
Second Address | Atlanta, GA 30308-2208 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/01/2008 |
Last Update Date | 06/08/2015 |