| NPI | 1568181717 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY AYERS Credentialing Manager 803-935-8292 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology Female Pelvic Medicine and Reconstructive Surgery |
| Additional Taxonomies | 2088F0040X Urology Female Pelvic Medicine and Reconstructive Surgery |
| Enumeration Date | 2022-08-23 |
| Last Update Date | 2022-08-23 |