NPI | 1215221353 |
---|---|
Entity Type | Organization |
Authorized Contact | DEIDRE WELLER Controller 269-945-1212 |
Organization Subpart ? | Yes |
Primary Taxonomy | 208600000X Surgery |
Additional Taxonomies | 207R00000X Internal Medicine |
207Q00000X Family Medicine | |
Enumeration Date | 2011-06-07 |
Last Update Date | 2016-04-22 |