| NPI | 1780933937 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENIS A BOUBOULIS Medical Doctor/Owner 203-202-7799 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: CT 029667) |
| Enumeration Date | 2012-09-04 |
| Last Update Date | 2013-01-14 |