| NPI | 1194208892 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIDINE CO President 915-269-0064 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology |
| Enumeration Date | 2018-09-10 |
| Last Update Date | 2020-09-22 |