| NPI | 1205958519 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL B EVAN President 330-707-1425 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2008-04-10 |