| NPI | 1871340281 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JORDAN MICHAEL SHAPIRO Owner/President 920-539-1288 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology |
| Enumeration Date | 2024-05-02 |
| Last Update Date | 2024-05-02 |