| NPI | 1659754745 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BOGDAN VATRA Sole Proprietor 607-756-9470 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2015-07-07 |
| Last Update Date | 2015-07-24 |