| NPI | 1225182272 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VANCE ANDRE' RAHAM President 765-825-0811 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: IN 01045645) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2020-08-22 |