| NPI | 1295757250 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SURESH GOPALAKRISHNA PRABHU Owner 702-256-3637 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV 9867) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2011-11-02 |