| NPI | 1073577482 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID GONZALEZ Credentialing Contact 570-622-5455 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2006-04-13 |
| Last Update Date | 2008-04-11 |