| NPI | 1902126030 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VASIREDDY BHOOPAL Family Practice 708-388-4911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 173000000X Legal Medicine (Licence: IL 036056748) |
| Enumeration Date | 2010-06-11 |
| Last Update Date | 2010-06-11 |