| NPI | 1164452900 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN KAE GABBARD Practice Administrator 937-523-9555 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OH 207RC0000X) |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2017-01-30 |