| NPI | 1952498347 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAHENDRA C MARU President 270-689-1919 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2017-07-12 |