| NPI | 1922246842 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBIN L RIGGS Manager 2562-652-4104 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: AL 10983) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AL 20726) |
| 208000000X Pediatrics (Licence: AL 24555) | |
| 208000000X Pediatrics (Licence: AL 25009) | |
| 208000000X Pediatrics (Licence: AL 17519) | |
| 208000000X Pediatrics (Licence: AL 17492) | |
| Enumeration Date | 2009-01-30 |
| Last Update Date | 2009-01-30 |