| NPI | 1376735951 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLA DIONNE WILLIS Office Manager 317-291-1211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01060259A) |
| Enumeration Date | 2007-08-16 |
| Last Update Date | 2008-04-17 |