| NPI | 1457630105 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY L BAHNSEN Credentialing Supervisor 419-824-7334 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease |
| Enumeration Date | 2011-08-12 |
| Last Update Date | 2011-08-12 |