| NPI | 1235750316 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PADMALATHA DHARANIKOTA President 687-492-9804 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine |
| Enumeration Date | 2020-04-30 |
| Last Update Date | 2020-04-30 |