| NPI | 1306455530 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SYED K SHAH Md/Owner 888-316-4767 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 208000000X Pediatrics |
| Enumeration Date | 2020-07-23 |
| Last Update Date | 2020-07-23 |