363LA2100X
South Bend, IN
Specialty
363LA2100X
Credential
NP
NPI
1558704445
211 N. Eddy St., South Bend, IN 46617
(574) 234-8161Confirm current license and practice information on the official CMS NPI registry.
View NPI RecordThis surgeon specializes in 363la2100x procedures performed in an outpatient ambulatory surgical setting.
NUCC Taxonomy: 363LA2100X