Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | 054494 | GA |
NPI | 1295721348 |
---|---|
Provider Name | Laura Effinger Harris |
First Address | Atlanta, GA 30309-1710 |
Second Address | Atlanta, GA 30309-1710 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2005 |
Last Update Date | 08/07/2007 |