| NPI | 1144632662 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELE J GAINS Managing Owner 601-574-0358 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: MS 21681) |
| Enumeration Date | 2014-06-02 |
| Last Update Date | 2014-06-02 |