NPI | 1093973356 |
---|---|
Former Name | KRUPALI MALAY THACKER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: NY 056445) |
Additional Taxonomies | 122300000X Dentist (Licence: IL 019027638) |
Enumeration Date | 2008-05-22 |
Last Update Date | 2019-07-17 |