| NPI | 1407037260 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXANDRIA BERRETTONI Billing/Credentialing Supervisor 219-662-3931 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: IN 01047404A) |
| Additional Taxonomies | 207RS0012X Internal Medicine, Sleep Medicine (Licence: IN 01047404A) |
| Enumeration Date | 2007-11-21 |
| Last Update Date | 2017-08-01 |