| NPI | 1063691269 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTIN KNUEVEN Credentialing Supervisor 567-585-1969 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080P0205X Pediatrics Pediatric Endocrinology |
| Enumeration Date | 2007-10-24 |
| Last Update Date | 2021-02-05 |