| NPI | 1497399927 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDON ZABUKOVIC Managing Member 574-274-9425 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208000000X Pediatrics |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2019-10-28 |
| Last Update Date | 2020-07-10 |