| NPI | 1518032325 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINA GREELY Office Manager 920-739-5213 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: WI 34066021) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: WI 2845520) |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2022-08-18 |