| NPI | 1639309735 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINA ROOD Sr It Syst EMS Analyst 234-312-5193 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology Gynecologic Oncology |
| Additional Taxonomies | 207VH0002X Obstetrics & Gynecology Hospice and Palliative Medicine |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2009-07-23 |
| Last Update Date | 2023-09-14 |