NPI | 1629395868 |
---|---|
Former Name | ANNAMMA KOOTUMKAL CHACKO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209.007801041.251125) |
Enumeration Date | 2010-04-28 |
Last Update Date | 2021-04-27 |