| NPI | 1427416494 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY N SANFORD Owner 618-288-2970 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 363A00000X Physician Assistant | |
| 367A00000X Advanced Practice Midwife | |
| Enumeration Date | 2016-02-05 |
| Last Update Date | 2016-02-05 |