Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | 328024 | LA |
NPI | 1477845667 |
---|---|
Provider Name | Renee Antonette Cowan |
First Address | Baton Rouge, LA 70817 |
Second Address | Baton Rouge, LA 70817-5129 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/05/2011 |
Last Update Date | 15/09/2021 |