| NPI | 1952675969 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DALE VICTOR BAUMAN Owner/Sole Proprietor 318-752-1502 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: LA MD.04029R) |
| Enumeration Date | 2012-03-08 |
| Last Update Date | 2012-03-08 |