| NPI | 1518398270 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID E WILMOT Owner/Sole Proprietor 317-408-3056 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01038693A) |
| Enumeration Date | 2013-12-06 |
| Last Update Date | 2013-12-06 |