| NPI | 1124680509 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY UTZ Director Of Lmp 419-998-4668 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207RC0000X Internal Medicine Cardiovascular Disease | |
| 207V00000X Obstetrics & Gynecology | |
| Enumeration Date | 2019-07-05 |
| Last Update Date | 2025-03-10 |