| NPI | 1528394731 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARC NUSHOLTZ Owner 260-312-6397 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine |
| 207RP1001X Internal Medicine, Pulmonary Disease | |
| Enumeration Date | 2009-10-22 |
| Last Update Date | 2009-10-22 |