| NPI | 1295794154 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BOB A ARCHULETA President CEO 804-320-7139 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 174400000X Specialist |
| 174400000X Specialist | |
| Enumeration Date | 2006-03-20 |
| Last Update Date | 2020-09-23 |