| NPI | 1063130383 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOAZZAM HABIB Owner 317-590-2604 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine |
| Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism |
| Enumeration Date | 2022-08-22 |
| Last Update Date | 2022-08-22 |