| NPI | 1407094550 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YOUHANNA S. AL-TAWIL Owner 865-546-3998 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics Pediatric Gastroenterology |
| Additional Taxonomies | 103T00000X Psychologist |
| 133V00000X Dietitian, Registered | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2009-01-28 |
| Last Update Date | 2009-01-28 |