| NPI | 1962501627 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID CYTLAK VP 4194-423-5497 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 207RE0101X Internal Medicine Endocrinology, Diabetes & Metabolism | |
| 207RP1001X Internal Medicine Pulmonary Disease | |
| 207V00000X Obstetrics & Gynecology | |
| 208000000X Pediatrics | |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: OH 35088792) | |
| 363LF0000X Nurse Practitioner Family | |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2013-09-19 |