| NPI | 1093129355 |
|---|---|
| Former Name | SOUJANYA KOTTAPALLI |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 30074) |
| Additional Taxonomies | 122300000X Dentist (Licence: VA 0030074) |
| Enumeration Date | 2014-06-16 |
| Last Update Date | 2017-11-07 |