| NPI | 1598217507 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAJA GIDWANI Office Manager 844-443-9264 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: FL ME109293) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME111199) |
| Enumeration Date | 2016-10-26 |
| Last Update Date | 2016-10-26 |