| NPI | 1245686989 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VISHAAL VEERULA Medical Director 260-475-0772 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207N00000X Dermatology |
| Enumeration Date | 2016-05-12 |
| Last Update Date | 2018-04-18 |