| NPI | 1629755756 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAVINDER VALADRI Owner 404-200-1373 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2023-06-30 |
| Last Update Date | 2023-06-30 |