| NPI | 1457667461 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MANOJ H MAJMUDAR Owner 270-886-8840 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2010-08-27 |
| Last Update Date | 2011-03-24 |