| NPI | 1609866722 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ORVILLE C ROSE Executive Director 904-503-1132 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: IN 01036485) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: IL 036068254) |
| Enumeration Date | 2005-10-28 |
| Last Update Date | 2024-02-20 |