| NPI | 1063687176 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WAYNE GIBSON Owner 812-218-9845 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: IN 01040911a) |
| Enumeration Date | 2008-04-29 |
| Last Update Date | 2013-05-06 |