| NPI | 1376668780 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEN H PARK President And CEO 317-580-6314 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology Neurology with Special Qualifications in Child Neurology |
| Additional Taxonomies | 2084P2900X Psychiatry & Neurology Pain Medicine |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2008-01-08 |