| NPI | 1245874635 |
|---|---|
| Doing Business As | SHANTHI R GOPI |
| Entity Type | Organization |
| Authorized Contact | SHANTHI R GOPI President 815-726-0311 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Enumeration Date | 2019-10-29 |
| Last Update Date | 2019-10-29 |