NPI | 1255772307 |
---|---|
Former Name | JENNIFER VARGHESE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 315296) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: CT 52266) |
Enumeration Date | 2013-07-17 |
Last Update Date | 2024-07-17 |