Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Pediatric Allergy/Immunology |
2080P0201X | 37 | Physician/Pediatric Medicine |
| NPI Number | 1942358213 |
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| LBN Legal business name | UPA PLLC DIV OF ALLERGY | ||||
| Authorized official | OWEN EVANS - (MANAGER) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | No | ||||
| Enumeration date | 01/05/2007 | ||||
| Last updated | 08/22/2020 - About 6 years ago | ||||
| Identifiers |
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