| NPI | 1730317272 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VENKATA S ERELLA Owner 812-391-3949 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery |
| Additional Taxonomies | 208600000X Surgery |
| Enumeration Date | 2009-06-23 |
| Last Update Date | 2009-06-23 |