| NPI | 1033644653 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAGHU SHANTAN REDDY MARRI Owner 630-776-4711 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2017-04-21 |
| Last Update Date | 2017-09-22 |