| NPI | 1154620169 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EARL B MALLY Senior Vice President 904-376-4275 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME62735) |
| Enumeration Date | 2011-03-17 |
| Last Update Date | 2011-03-17 |