| NPI | 1033222633 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSIE HANSEN Administrator 317-841-8090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: IN 50002167A) |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2015-05-04 |