| NPI | 1376651091 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANICE NICOLE YOUNG Provider 239-591-3311 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: FL ME62510) |
| Additional Taxonomies | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: FL ME62510) |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2023-01-16 |