| NPI | 1982887402 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLINE MATVYA Owner 269-450-3096 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IN 71001142A) |
| Enumeration Date | 2007-12-06 |
| Last Update Date | 2007-12-06 |