| NPI | 1811762701 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTINA MUSIC Director Of Provider Enrollment 877-892-9815 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine |
| Additional Taxonomies | 207P00000X Emergency Medicine |
| 208M00000X Hospitalist | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| 363LN0000X Nurse Practitioner, Neonatal | |
| 363LP0200X Nurse Practitioner, Pediatrics | |
| Enumeration Date | 2023-11-20 |
| Last Update Date | 2024-04-10 |