| NPI | 1760716351 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH H GATEWOOD Owner 800-732-1066 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| 207P00000X Emergency Medicine | |
| Enumeration Date | 2009-09-29 |
| Last Update Date | 2010-06-10 |