| NPI | 1144721432 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PIYUSH GUPTA Owner 888-291-1358 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2018-02-22 |
| Last Update Date | 2018-08-22 |