| NPI | 1477369528 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUAN MARTIN LOPEZ CUERVO Manager 317-890-0600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207QB0002X Family Medicine Obesity Medicine |
| Enumeration Date | 2024-12-04 |
| Last Update Date | 2024-12-04 |