| NPI | 1366651242 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARIMA GUPTA Credentialing Specialist 937-424-2215 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2023-05-11 |