| NPI | 1770751059 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MISTY A BARKER Credentialing 440-617-1823 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207RG0300X Internal Medicine Geriatric Medicine |
| Enumeration Date | 2008-02-20 |
| Last Update Date | 2009-03-18 |