| NPI | 1184817660 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHANIEL HARVEY HIMELSTEIN Sole Member 317-253-8303 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01020452A) |
| Enumeration Date | 2007-08-20 |
| Last Update Date | 2007-08-20 |