| NPI | 1144365669 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY GOVAN Credentialing Specialist 419-824-7221 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics Pediatric Gastroenterology |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2022-07-21 |