| NPI | 1881749604 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARYANN THERESE FUMO Owner 219-879-0333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01036532A) |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2007-10-25 |