NPI | 1609417005 |
---|---|
Former Name | SARAH BETH KURUVILLA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 36631) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS042449) |
1223G0001X Dentist, General Practice (Licence: NM DD5216) | |
Enumeration Date | 2019-10-07 |
Last Update Date | 2021-10-20 |