| NPI | 1689424160 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDI B NELSON Owner 347-230-4076 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 207Q00000X Family Medicine | |
| Enumeration Date | 2024-03-26 |
| Last Update Date | 2024-07-26 |