| NPI | 1841522620 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSE JORGE GORDINHO Physician/Owner 304-860-1931 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: WV 82326001) |
| Enumeration Date | 2010-02-04 |
| Last Update Date | 2015-09-10 |