| 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 |