| NPI | 1568545440 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATTAYA KULLAVAN President 319-364-5191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: IA 20556) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2020-08-22 |