| NPI | 1154477305 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SRILATHA KODALI Owner 603-635-2802 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2007-01-28 |
| Last Update Date | 2024-04-11 |