| NPI | 1578719571 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM BASTIAN Provider/Owner 601-376-1545 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: MS 19260) |
| Enumeration Date | 2008-08-11 |
| Last Update Date | 2008-08-11 |