| NPI | 1821098609 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NIKOLA T ALAIN Medical Director 937-644-1920 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OH 35-083181) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35-050943) |
| 208000000X Pediatrics (Licence: OH 34-007191) | |
| Enumeration Date | 2005-07-22 |
| Last Update Date | 2020-08-22 |