NPI | 1124546759 |
---|---|
Former Name | SAPNA MARY VARGHESE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: TX 35661) |
Additional Taxonomies | 122300000X Dentist (Licence: IL 319020673) |
1223G0001X Dentist, General Practice (Licence: TX 35661) | |
Enumeration Date | 2017-09-04 |
Last Update Date | 2024-09-13 |