| NPI | 1699532028 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATOYA ELAM Ibo 470-608-2286 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2024-03-04 |
| Last Update Date | 2024-03-04 |