| NPI | 1013194356 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER DAWSON Director Of Billing 765-446-5417 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: IN 01034584A) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IN 01034584A) |
| Enumeration Date | 2008-01-29 |
| Last Update Date | 2024-10-18 |