| NPI | 1104173533 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIDYA SAGAR RAO MORISETTY Owner 217-875-1886 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: IL 036084779) |
| Enumeration Date | 2012-08-03 |
| Last Update Date | 2014-07-17 |