| NPI | 1962874628 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS J MOORE Owner 606-215-1793 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: KY 22596) |
| Enumeration Date | 2015-10-21 |
| Last Update Date | 2015-10-21 |