| NPI | 1962774018 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANUJA TIRUNAGARI VEDERE Physician Owner 772-335-7888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: FL ME76026) |
| Enumeration Date | 2012-02-06 |
| Last Update Date | 2012-02-06 |