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NPI Profile for PPGNW IDAHO in MERIDIAN, ID.
A physician who specializes in diagnosis, treatment, and management of patients with gynecologic conditions.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Gynecology |
207VG0400X | 16 | Physician/Obstetrics & Gynecology |
| NPI # | 1760884324 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 09/25/2014 | |
| Last updated | 09/25/2014 - About 12 years ago | |
| Sole proprietor 1 | Not specified | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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PPGNW - IDAHO
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PPGNW - IDAHO