| NPI | 1962215129 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTINA KAY LOWERY Credentialing Manager 317-919-9025 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology |
| Enumeration Date | 2025-01-30 |
| Last Update Date | 2025-01-30 |