| NPI | 1114364189 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT WALTER HEISER Owner 239-206-4919 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME51095) |
| Enumeration Date | 2013-05-30 |
| Last Update Date | 2013-06-11 |