| NPI | 1164654851 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NITYANAND D GUPTA Owner 270-240-5696 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2009-08-14 |
| Last Update Date | 2014-01-07 |