NPI | 1154683472 |
---|---|
Entity Type | Organization |
Authorized Contact | JEAN LANGLEY ROBERTS Member/M.D. 765-760-2840 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01067670A) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: IN 01067670A) |
Enumeration Date | 2012-06-12 |
Last Update Date | 2012-06-12 |