| NPI | 1932304417 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE L HOLLAND Office Manager 260-824-4315 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: IN 01023363) |
| Enumeration Date | 2007-06-15 |
| Last Update Date | 2007-11-15 |