Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | 36409 | IA |
NPI | 1043276017 |
---|---|
Provider Name | Dr. Brian Christopher Cooper |
First Address | Clive, IA 50325-8143 |
Second Address | Clive, IA 50325-8143 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2006 |
Last Update Date | 08/07/2007 |