| NPI | 1053319871 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDSAY A MCALLEN Credentialing Specialist 330-759-6750 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 207V00000X Obstetrics & Gynecology | |
| 208600000X Surgery (Licence: PA MD039604L) | |
| Enumeration Date | 2005-07-14 |
| Last Update Date | 2022-07-21 |