| NPI | 1992116263 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHERINE HENDRICKSON Office Manager 619-312-1562 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: CA C53475) |
| Enumeration Date | 2014-05-08 |
| Last Update Date | 2017-01-13 |