| NPI | 1265802052 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENOIT D TANO Md/Owner 952-222-3879 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207KA0200X Allergy & Immunology Allergy (Licence: MN 56126) |
| Enumeration Date | 2015-10-06 |
| Last Update Date | 2022-09-20 |