| NPI | 1225366214 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NKENGE AYEOLA JACKSON President 912-920-2995 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: GA 058969) |
| Enumeration Date | 2009-12-02 |
| Last Update Date | 2011-09-11 |