| NPI | 1184820680 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL MACIAL Owner 269-781-3461 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: MI 4301082908) |
| Enumeration Date | 2007-06-22 |
| Last Update Date | 2020-08-22 |