| NPI | 1346510559 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIELLE STUART Credentialing Specialist 601-200-4880 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology Gynecologic Oncology |
| Enumeration Date | 2012-01-04 |
| Last Update Date | 2021-03-16 |