| NPI | 1861626194 |
|---|---|
| Former Name | SHANTI PRIYA KOILAKONDA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2012-01435) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT194250) |
| Enumeration Date | 2009-05-14 |
| Last Update Date | 2021-05-08 |