| NPI | 1023990173 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANA NTODI Owner 210-570-2450 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| 363LP0200X Nurse Practitioner, Pediatrics | |
| Enumeration Date | 2025-07-21 |
| Last Update Date | 2025-09-14 |