| NPI | 1285892752 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JODIE HATTERY Credentialing Coordinator 260-969-7173 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: IN 01041346) |
| Enumeration Date | 2008-05-30 |
| Last Update Date | 2008-05-30 |