| NPI | 1548513799 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY J SULLIVAN Medical Doctor 801-387-4850 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207KA0200X Allergy & Immunology Allergy (Licence: UT 8263858-1205) |
| Enumeration Date | 2012-10-24 |
| Last Update Date | 2012-10-24 |