| NPI | 1386848133 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YVETTE LONGFELLOW Office Manager 765-626-0056 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: IN 01037318) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2009-01-22 |