| NPI | 1649456443 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WALTER R GIL Owner 772-403-5860 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME0050565) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME98874) |
| Enumeration Date | 2008-01-11 |
| Last Update Date | 2008-01-11 |