| NPI | 1316072242 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL SETH MILLER Owner 317-429-0061 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 208600000X Surgery (Licence: IN 02001905) |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2023-03-05 |