| NPI | 1629329016 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARILON GREEN-HICKSON President/Owner 757-802-0209 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207KI0005X Allergy & Immunology Clinical & Laboratory Immunology |
| Enumeration Date | 2012-09-25 |
| Last Update Date | 2019-04-05 |