| NPI | 1205960226 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BECKY MARKWARD Office Manager 235-383-4721 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207KI0005X Allergy & Immunology, Clinical & Laboratory Immunology (Licence: WA md00026151) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2012-10-17 |