| NPI | 1194037150 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIA BANTA Om/Cma 330-456-9939 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OH 34.008837) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35.047428) |
| Enumeration Date | 2010-07-07 |
| Last Update Date | 2025-07-22 |