| NPI | 1841390390 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAMLESH S SHAH Physician 307-577-5222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: WY 5881A) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: CO 38777) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2020-08-22 |