| NPI | 1194263962 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAVIKANTH CHIRAVURI Officer 772-888-2545 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| Enumeration Date | 2017-02-01 |
| Last Update Date | 2017-02-01 |