| NPI | 1346724184 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FARZANA N TAUSIF Owner 419-754-1030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2018-09-18 |
| Last Update Date | 2018-09-18 |