| NPI | 1093748253 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA A GOLDBERG Executive Director 317-924-8297 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology |
| Additional Taxonomies | 207KA0200X Allergy & Immunology, Allergy |
| 363L00000X Nurse Practitioner | |
| 363LF0000X Nurse Practitioner, Family | |
| 363LA2200X Nurse Practitioner, Adult Health | |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2013-03-11 |