| NPI | 1962690735 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHIVAPRASAS K SHETTY President 419-335-2811 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35-06-8087S) |
| Enumeration Date | 2007-10-05 |
| Last Update Date | 2007-10-05 |