| NPI | 1538688163 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSSEL B COUTINHO Owner 812-239-3836 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics Neonatal-Perinatal Medicine (Licence: IN 01060691A) |
| Enumeration Date | 2017-09-14 |
| Last Update Date | 2017-09-14 |