NPI | 1891574927 |
---|---|
Entity Type | Organization |
Authorized Contact | ANGELICA ROBLES Chief Medical Officer 980-890-8668 |
Organization Subpart ? | No |
Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics |
Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
Enumeration Date | 2023-09-27 |
Last Update Date | 2024-11-13 |