| NPI | 1104400563 |
|---|---|
| Other Name | MISO EAGAN |
| Entity Type | Organization |
| Authorized Contact | TERRY LAYMAN Corporate Medical Officer 317-727-6898 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Enumeration Date | 2021-05-11 |
| Last Update Date | 2022-10-20 |