| NPI | 1518370261 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN LOVEJOY ROQUE Owner 980-223-8535 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NC 9500440) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 161312) |
| Enumeration Date | 2014-06-10 |
| Last Update Date | 2014-07-16 |