| NPI | 1770556532 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOAN SERVIS Credentialing Specialist 937-396-2602 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2020-01-14 |