| NPI | 1679763569 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAKSHMANA MADALA Sole Proprietor 989-752-1900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine |
| Enumeration Date | 2007-07-27 |
| Last Update Date | 2012-02-22 |