| 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 | 2023-12-07 |