| NPI | 1184285496 |
|---|---|
| Former Name | JATHA SUSAN MATHEW |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 22785) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: SC 22785) |
| Enumeration Date | 2019-06-26 |
| Last Update Date | 2021-07-28 |