| NPI | 1245618677 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GANESH ASAITHAMBI Owner/Provider 681-207-7129 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WV 24076) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: WV 24136) |
| Enumeration Date | 2015-05-18 |
| Last Update Date | 2022-05-04 |