| NPI | 1770967093 |
|---|---|
| Former Name | DEEPA SELVAKUMAR |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: RI DEN03477) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA DN1856959) |
| Enumeration Date | 2015-07-16 |
| Last Update Date | 2019-09-18 |