NPI | 1285146589 |
---|---|
Former Name | SIRISHA MUNIMADUGU |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0300X Dentist Periodontics (Licence: WA DE60951176) |
Additional Taxonomies | 1223P0300X Dentist Periodontics (Licence: TX 32775) |
Enumeration Date | 2017-10-26 |
Last Update Date | 2022-04-29 |