| NPI | 1639301633 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MILTON GILES FORT Owner 225-216-3006 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology Gynecologic Oncology |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology Gynecology |
| Enumeration Date | 2009-08-10 |
| Last Update Date | 2011-03-21 |