| NPI | 1477800225 |
|---|---|
| Former Name | SIREESHA BOGANATHAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KS 61308) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019029203) |
| Enumeration Date | 2012-08-11 |
| Last Update Date | 2024-03-22 |