| NPI | 1790718765 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS L GRAY President/Partner 260-483-6448 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: IN 50000046A) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2020-08-22 |