NPI | 1669664009 |
---|---|
Former Name | CHETHANA CHANDRUPATLA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: MI 4301108548) |
Additional Taxonomies | 207N00000X Dermatology (Licence: FL ME116448) |
207N00000X Dermatology (Licence: IL 036.122055) | |
Enumeration Date | 2007-08-09 |
Last Update Date | 2018-08-22 |