| NPI | 1528246683 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURIE M TATE Credentialing 330-263-8763 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35077131) |
| Enumeration Date | 2008-01-31 |
| Last Update Date | 2015-02-05 |