| NPI | 1174251227 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY JOYCE GAN Md 863-825-6121 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080P0205X Pediatrics, Pediatric Endocrinology |
| Additional Taxonomies | 208000000X Pediatrics |
| Enumeration Date | 2022-08-08 |
| Last Update Date | 2022-11-28 |