| NPI | 1679520712 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACY ELAINE ROBERTS Practice Manager 269-969-6100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2013-09-30 |