| NPI | 1588749618 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACOB LEON GLOCK President 239-561-3430 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207VE0102X Obstetrics & Gynecology, Reproductive Endocrinology (Licence: FL ME0057264) |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2009-01-12 |