| NPI | 1457396541 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA S HANELINE Secretary Treasurer 317-777-6435 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 103T00000X Psychologist |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2024-05-08 |