| NPI | 1306609003 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA ROSE POULIN CEO 307-205-3084 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207VM0101X Obstetrics & Gynecology Maternal & Fetal Medicine |
| Enumeration Date | 2024-02-05 |
| Last Update Date | 2024-05-21 |