| NPI | 1891945440 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA LASTER Office Mgr 662-563-2608 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology |
| Enumeration Date | 2008-09-19 |
| Last Update Date | 2008-09-19 |