| NPI | 1386975415 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LANCE ANDRE MAKI President 321-305-6254 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: FL ME92412) |
| Enumeration Date | 2010-01-29 |
| Last Update Date | 2011-04-11 |