NPI | 1992088082 |
---|---|
Former Name | DIANE M. BAMGBADE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: NJ 25MA09377500) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
207V00000X Obstetrics & Gynecology (Licence: NJ 25MA09377500) | |
Enumeration Date | 2011-09-24 |
Last Update Date | 2020-03-12 |