| NPI | 1730724501 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE MARIE AYLWARD Administrator 800-416-0888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology |
| Enumeration Date | 2019-11-15 |
| Last Update Date | 2020-02-28 |