| NPI | 1427514306 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY JO UECKER Business Manager 269-420-9404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology |
| Enumeration Date | 2019-02-15 |
| Last Update Date | 2019-05-02 |