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1043906894
PRAJWAL BASANNA KERANALLI
SAINT LOUIS, MO
NPI
1043906894
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2023-04-14
Last Update Date
2023-04-24
Business Address
PRAJWAL BASANNA KERANALLI MD
1201 S GRAND BLVD
SAINT LOUIS, MO 63104-1016
Phone number: 314-617-3749
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Mailing Address
PRAJWAL BASANNA KERANALLI MD
105 SWEET CHERRY WAY
WILDWOOD, MO 63040-2146
Phone number: 301-728-9565
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