NPI | 1942917380 |
---|---|
Entity Type | Organization |
Authorized Contact | PHANI MOHAN VUPADHYAYULA Member 704-813-7476 |
Organization Subpart ? | No |
Primary Taxonomy | 207R00000X Internal Medicine |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation |
261QM1300X Clinic/Center Multi-Specialty | |
Enumeration Date | 2022-11-04 |
Last Update Date | 2024-08-29 |