NPI | 1316310782 |
---|---|
Entity Type | Organization |
Authorized Contact | SAMSON M. CHAN Medical Director 317-908-8833 |
Organization Subpart ? | No |
Primary Taxonomy | 202K00000X (Licence: IL 036134419) |
Additional Taxonomies | 208600000X Surgery (Licence: IL 036134419) |
Enumeration Date | 2015-11-07 |
Last Update Date | 2015-11-07 |