NPI | 1154195428 |
---|---|
Entity Type | Organization |
Authorized Contact | BRIAN EDWARD PEDDIE CEO 765-652-4060 |
Organization Subpart ? | No |
Primary Taxonomy | 2080P0214X Pediatrics, Pediatric Pulmonology |
Additional Taxonomies | 208000000X Pediatrics |
Enumeration Date | 2023-11-08 |
Last Update Date | 2023-11-08 |