| NPI | 1477741304 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ORVILLE C ROSE Executive Director 904-503-1132 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: IL 036053172) |
| Enumeration Date | 2007-10-04 |
| Last Update Date | 2024-05-23 |