| NPI | 1003205402 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MURSHID K ABDEL-LATIF Owner 304-212-5620 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: WV 17237) |
| Additional Taxonomies | 176B00000X Midwife (Licence: WV 50130) |
| Enumeration Date | 2015-01-22 |
| Last Update Date | 2016-11-09 |