| NPI | 1548230923 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW V DZURIK President, Ccpn 682-885-1416 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics |
| Additional Taxonomies | 208000000X Pediatrics |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2025-01-31 |