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1073263992
INGMAR NIELS BASTIAN
HOUSTON, TX
NPI
1073263992
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207V00000X Obstetrics & Gynecology
(Licence: WI Student)
Enumeration Date
2022-03-24
Last Update Date
2022-03-24
Business Address
INGMAR NIELS BASTIAN Student
1 BAYLOR PLZ
HOUSTON, TX 77030-3411
Phone number: 832-826-7354
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Mailing Address
INGMAR NIELS BASTIAN Student
3006 BLUFF ST
MADISON, WI 53705-3422
Phone number: 415-272-9528
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