| NPI | 1477653897 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNIS PATRICK SULLIVAN Physician 937-399-8921 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: OH 35-037690) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2010-02-01 |