Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 170100000X | Medical Geneticist |
NPI | 1629102843 |
---|---|
Provider Name | Murty Vundavalli |
First Address | New York, NY 10032-3720 |
Second Address | New York, NY 10032-3720 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2007 |
Last Update Date | 08/07/2007 |