| NPI | 1861527384 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN D WULFF Md 765-288-6828 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IN 01028724) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IN 01041561) |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2020-08-22 |