| 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 |