| NPI | 1285824979 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MABBU G SHIVAPRASAD Physician 937-593-3151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: OH 35072257) |
| Enumeration Date | 2007-07-28 |
| Last Update Date | 2007-07-28 |