| NPI | 1205240025 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAMATHA R GADARLA Owner 704-726-4358 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA08121700) |
| Enumeration Date | 2014-06-19 |
| Last Update Date | 2024-06-05 |