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 |