| NPI | 1104207505 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUTH DWYER President 317-253-1644 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71002957A) |
| Enumeration Date | 2015-06-11 |
| Last Update Date | 2015-10-14 |