| NPI | 1356377915 |
|---|---|
| Former Name | IMMARAJU JOEL PREMSWARUP |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX L4655) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX L4655) |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2020-02-28 |