| NPI | 1770055238 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COURTNEY IVESS Associate Director, Credentialing 571-366-8831 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology |
| Additional Taxonomies | 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine |
| 207VX0000X Obstetrics & Gynecology, Obstetrics | |
| 207VF0040X Obstetrics & Gynecology, Female Pelvic Medicine and Reconstructive Surgery | |
| 207VG0400X Obstetrics & Gynecology, Gynecology | |
| Enumeration Date | 2018-12-21 |
| Last Update Date | 2018-12-21 |