| NPI | 1063668614 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANGA RAO KOTA Owner 219-759-5812 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: IN 01038987) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01038987) |
| Enumeration Date | 2008-08-14 |
| Last Update Date | 2013-03-28 |