NPI | 1124790977 |
---|---|
Entity Type | Organization |
Authorized Contact | LAUREN LAU Credentialing 724-989-4564 |
Organization Subpart ? | No |
Primary Taxonomy | 207K00000X Allergy & Immunology |
Additional Taxonomies | 133N00000X Nutritionist |
207R00000X Internal Medicine | |
Enumeration Date | 2021-09-30 |
Last Update Date | 2021-09-30 |