| NPI | 1740050608 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MUTHUKUMAR VELLAICHAMY Owner 234-260-6212 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics |
| 207NP0225X Dermatology, Pediatric Dermatology | |
| 2080A0000X Pediatrics, Adolescent Medicine | |
| 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics | |
| 2080P0202X Pediatrics, Pediatric Cardiology | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine | |
| Enumeration Date | 2024-01-03 |
| Last Update Date | 2024-01-03 |