| NPI | 1346889292 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VALLISITARAM PRASAD KODALI Owner 919-650-6461 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology |
| Enumeration Date | 2019-12-24 |
| Last Update Date | 2019-12-24 |