| NPI | 1265773402 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTHA K MILLER Director Of Billing 765-446-5286 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology |
| Enumeration Date | 2013-03-13 |
| Last Update Date | 2013-07-17 |