| NPI | 1568642601 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARIQ IBRAHIM Physician 219-513-2333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: IN 01062605A) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IN 01062605A) |
| Enumeration Date | 2007-11-06 |
| Last Update Date | 2015-04-20 |