NPI | 1811969918 |
---|---|
Entity Type | Organization |
Authorized Contact | TANYA ELAINE REID Owner 803-400-1201 |
Organization Subpart ? | No |
Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: SC 15941) |
Additional Taxonomies | 208000000X Pediatrics (Licence: SC 15941) |
Enumeration Date | 2006-02-02 |
Last Update Date | 2020-08-22 |