| NPI | 1427068634 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARRIE LYNN GILLSON Office Manager 330-499-3377 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 01397525) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 01397525) |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2024-01-29 |