| NPI | 1982096822 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTENA OESTREICH Office Manager 219-548-0360 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IN 10001797a) |
| Enumeration Date | 2015-03-02 |
| Last Update Date | 2015-03-02 |