| NPI | 1104961960 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARINUS PIETER SPIERENBURG Office Manager 641-792-6676 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IA 32610) |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2020-08-22 |