NPI | 1396530572 |
---|---|
Entity Type | Organization |
Authorized Contact | TAMMY WALKER Provider Enrollment 561-300-2410 |
Organization Subpart ? | No |
Primary Taxonomy | 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine |
Enumeration Date | 2025-04-10 |
Last Update Date | 2025-04-10 |