| NPI | 1790892792 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLA R HEUN Credentialing Coordinator 440-892-6406 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2016-01-08 |