| NPI | 1659198141 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARGARETT ELLISON Owner 229-502-9681 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology |
| Enumeration Date | 2024-09-25 |
| Last Update Date | 2024-09-25 |