| NPI | 1952691057 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOANNA LOURDES SANTIESTEBAN Officer 606-886-1162 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2011-04-11 |
| Last Update Date | 2011-12-27 |