| NPI | 1033871447 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTIE WHITLATCH CEO 606-408-4401 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2021-10-13 |
| Last Update Date | 2021-10-13 |