| NPI | 1912210055 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAYADEVAN KUNDUMADATHIL Owner 321-473-8974 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME78547) |
| Enumeration Date | 2010-07-19 |
| Last Update Date | 2010-08-06 |