| NPI | 1225295892 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILSON NICOLAS OTERO Registered Agent/Gastroenterologist 954-483-8422 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: FL ME0044788) |
| Enumeration Date | 2008-05-20 |
| Last Update Date | 2008-05-20 |