| NPI | 1194096693 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY L BAHNSEN Credentialing Supervisor 419-824-7334 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine Pulmonary Disease |
| Additional Taxonomies | 207RS0012X Internal Medicine Sleep Medicine |
| Enumeration Date | 2012-01-16 |
| Last Update Date | 2012-01-16 |