| NPI | 1730198599 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THAIR R DIEFFENBACH Ph.D. 352-683-0232 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME55252) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH0002734) |
| Enumeration Date | 2006-08-07 |
| Last Update Date | 2013-03-19 |