NPI | 1841284296 |
---|---|
Former Name | RADHIKA PAVULURI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: MO 2001019373) |
Additional Taxonomies | 152W00000X Optometrist (Licence: KS 1607) |
Enumeration Date | 2005-08-31 |
Last Update Date | 2024-12-19 |