NPI | 1023353877 |
---|---|
Former Name | MINIMOL ANTONY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: IL 041.335478) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209010069) |
Enumeration Date | 2012-12-05 |
Last Update Date | 2012-12-05 |