NPI | 1285359752 |
---|---|
Other Name | INDIANA |
Entity Type | Organization |
Authorized Contact | CHRISTOPHER DENNIS Chief Medical Officer 657-237-2450 |
Organization Subpart ? | No |
Primary Taxonomy | 208D00000X General Practice |
Enumeration Date | 2022-10-07 |
Last Update Date | 2024-01-30 |