| NPI | 1104053487 |
|---|---|
| Former Name | MAHATHI MADIRAJU |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401411896) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 55947) |
| Enumeration Date | 2009-06-15 |
| Last Update Date | 2011-03-03 |