Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204E00000X | Oral & Maxillofacial Surgeon | DS043206 | PA |
NPI | 1245790153 |
---|---|
Provider Name | Roopali Kulkarni |
First Address | Philadelphia, PA 19104-5127 |
Second Address | Radnor, PA 19087-4557 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/03/2019 |
Last Update Date | 02/12/2021 |