| NPI | 1093040719 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BALAGOPAL KERALAVARMA Owner 219-742-4237 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: IN 01052677A) |
| Enumeration Date | 2009-10-14 |
| Last Update Date | 2022-01-13 |