NPI | 1003105099 |
---|---|
Former Name | CHAITU DEVULAPALLI |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: NY 307678) |
Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: NJ 25MA10972000) |
Enumeration Date | 2011-03-30 |
Last Update Date | 2023-04-17 |