| NPI | 1053133793 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PRAVEENA GANNI VELAMATI Director/Officer 410-224-2116 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology |
| Enumeration Date | 2024-10-24 |
| Last Update Date | 2024-10-24 |