| NPI | 1578770160 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTORIA DODSON Credentialing Manager 443-398-0189 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology Gynecology |
| Additional Taxonomies | 207VX0201X Obstetrics & Gynecology Gynecologic Oncology |
| 208600000X Surgery | |
| 363A00000X Physician Assistant (Licence: MD C0001760) | |
| 367A00000X Advanced Practice Midwife (Licence: MD R126791) | |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2025-05-21 |