| NPI | 1477519445 |
|---|---|
| Former Name | CHANNABASAVANNA BASAVA PRASAD |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: AZ 14827) |
| Additional Taxonomies | 174400000X Specialist (Licence: AZ 14827) |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2016-02-22 |