| NPI | 1669442042 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW V DZURIK President, Ccpn 682-885-1416 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine |
| Additional Taxonomies | 208000000X Pediatrics |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2021-06-29 |