| NPI | 1790180933 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN J GILLIS Owner/Provider 207-465-3003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: ME 1513) |
| Enumeration Date | 2014-10-30 |
| Last Update Date | 2014-10-30 |