| NPI | 1780124586 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SRIDHAR BOLLA President 317-228-3393 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2017-02-28 |
| Last Update Date | 2017-02-28 |