| NPI | 1265666408 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANA MARIA BORA Billing Manager 317-926-3739 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10001050A) |
| Enumeration Date | 2009-05-02 |
| Last Update Date | 2022-08-19 |