NPI | 1386674513 |
---|---|
Entity Type | Organization |
Authorized Contact | PAMELA CAWOOD Practice Administrator 765-966-5527 |
Organization Subpart ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 50000450A) |
Additional Taxonomies | 208000000X Pediatrics (Licence: IN 50000450A) |
Enumeration Date | 2006-07-04 |
Last Update Date | 2008-04-23 |