| NPI | 1861012031 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EILEEN GALLAGHER Manager 415-533-8138 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 261Q00000X |
| Enumeration Date | 2020-04-17 |
| Last Update Date | 2022-03-24 |