NPI | 1669993259 |
---|---|
Former Name | JESSY MEPURATHU PHILIP |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA GAA-NP001482) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5015335) |
363LF0000X Nurse Practitioner, Family (Licence: KY 3011452) | |
Enumeration Date | 2017-07-05 |
Last Update Date | 2023-08-16 |