| NPI | 1316497217 |
|---|---|
| Former Name | DEEPA JOSE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209014682) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041344849) |
| Enumeration Date | 2016-10-04 |
| Last Update Date | 2020-02-27 |