| NPI | 1245233725 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACOB DUDLEY ROUSE President 386-423-0333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME32999) |
| Additional Taxonomies | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: FL RN2893652) |
| Enumeration Date | 2005-05-27 |
| Last Update Date | 2012-09-07 |