NPI | 1902067598 |
---|---|
Entity Type | Organization |
Authorized Contact | BERYL LYNN RANDOLPH Owner 260-338-2048 |
Organization Subpart ? | No |
Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: IN 01055463) |
Enumeration Date | 2008-06-17 |
Last Update Date | 2008-06-17 |