| NPI | 1952721185 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIO ORTIZ Dean And Professor 574-520-5557 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01046709) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: IN 28076706A) |
| 164W00000X Licensed Practical Nurse (Licence: IN 28156667A) | |
| 302R00000X Health Maintenance Organization | |
| Enumeration Date | 2014-04-28 |
| Last Update Date | 2014-04-28 |