| NPI | 1740694421 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMMAR TAYARA Member 812-949-3242 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 363LG0600X Nurse Practitioner, Gerontology | |
| Enumeration Date | 2014-06-20 |
| Last Update Date | 2017-03-29 |