| NPI | 1942498548 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID A ELLIOTT Owner 772-288-1220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL OS6350) |
| Enumeration Date | 2007-10-09 |
| Last Update Date | 2007-10-10 |