| NPI | 1114660560 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA CHEN Assistant Secretary 800-243-3839 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology |
| Additional Taxonomies | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery |
| 208000000X Pediatrics | |
| 2086S0120X Surgery, Pediatric Surgery | |
| 2088P0231X | |
| 363A00000X Physician Assistant | |
| 363LF0000X Nurse Practitioner, Family | |
| 363LP0200X Nurse Practitioner, Pediatrics | |
| Enumeration Date | 2022-04-14 |
| Last Update Date | 2024-06-10 |