NPI | 1740453984 |
---|---|
Entity Type | Organization |
Authorized Contact | SUSAN BETH GRAU Physician 937-748-4211 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 350742546) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 34008059M) |
Enumeration Date | 2008-04-09 |
Last Update Date | 2008-04-09 |