| NPI | 1194118919 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNA THEISEN Account 786-475-3973 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: FL ME0050223) |
| Enumeration Date | 2015-03-18 |
| Last Update Date | 2015-03-18 |