| NPI | 1053496141 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID LEON DUGGER Owner 228-818-2450 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: MS 06909) |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2012-11-28 |