| NPI | 1790052090 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER M GRACE President 251-990-1960 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: AL 24538) |
| Enumeration Date | 2011-11-30 |
| Last Update Date | 2012-01-10 |