| NPI | 1174336572 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURIE BURNETT Executive Director 479-459-6658 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080C0008X Pediatrics, Child Abuse Pediatrics |
| Enumeration Date | 2025-01-29 |
| Last Update Date | 2025-01-29 |