| NPI | 1063513828 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDY KLEKOTA Credentialing COO Rdinator 440-233-1003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: OH 35035173) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2007-11-02 |