| NPI | 1881024271 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FADEL NAMMOUR Owner 701-356-1001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology |
| Enumeration Date | 2013-11-21 |
| Last Update Date | 2019-05-30 |