| NPI | 1972017549 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MUDALODU VASUDEVAN CEO 646-688-3579 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NV 17489) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301102270) |
| Enumeration Date | 2017-11-18 |
| Last Update Date | 2017-11-18 |