| NPI | 1497414387 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALAN OLIVER President 877-885-0588 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology Neurology with Special Qualifications in Child Neurology |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family |
| 363LP0200X Nurse Practitioner Pediatrics | |
| 2080P0008X Pediatrics Neurodevelopmental Disabilities | |
| Enumeration Date | 2021-12-08 |
| Last Update Date | 2021-12-10 |