| NPI | 1336387554 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUNDA REVANNA President 205-821-3944 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2009-01-26 |
| Last Update Date | 2009-01-26 |