NPI | 1568585016 |
---|---|
Entity Type | Organization |
Authorized Contact | LATISHA MARIE WISNIEWSKI Practice Administrator 228-702-1500 |
Organization Subpart ? | No |
Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology |
Enumeration Date | 2007-04-09 |
Last Update Date | 2008-04-07 |