| NPI | 1538928726 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ARVIND CHAKRAVARTHY Owner 810-814-0963 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2024-03-18 |
| Last Update Date | 2024-03-18 |