| NPI | 1245442177 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEO BONAVENTURA Owner 317-814-4570 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207VE0102X Obstetrics & Gynecology, Reproductive Endocrinology |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2010-09-10 |