| NPI | 1093146268 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIRK SHAFER CFO 765-288-1928 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 208000000X Pediatrics | |
| Enumeration Date | 2013-12-12 |
| Last Update Date | 2014-04-17 |