| NPI | 1265756951 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIPIKA P VERMA Practice Administrator 662-562-9003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MS MS14916) |
| Enumeration Date | 2010-03-24 |
| Last Update Date | 2012-02-29 |