| NPI | 1194170944 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK HOLBREICH Owner 317-574-0230 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207KI0005X Allergy & Immunology Clinical & Laboratory Immunology (Licence: IN 01035981) |
| Enumeration Date | 2016-04-29 |
| Last Update Date | 2016-04-29 |