| NPI | 1932156742 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETH L BRAKE Office Manager/Partner 937-644-1441 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH RN215818) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH RN186421) |
| 208000000X Pediatrics (Licence: OH 57093) | |
| 207Q00000X Family Medicine (Licence: OH 58625) | |
| 207R00000X Internal Medicine (Licence: OH 57093) | |
| 207K00000X Allergy & Immunology (Licence: OH 35073238M) | |
| 207R00000X Internal Medicine (Licence: OH 35073238M) | |
| 208000000X Pediatrics (Licence: OH 35073238M) | |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2020-08-22 |