| NPI | 1841343605 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OWEN B EVANS Manager 601-984-5214 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080P0006X Pediatrics Developmental - Behavioral Pediatrics |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2008-06-24 |