NPI | 1679194278 |
---|---|
Former Name | CHRYSTAL MATTAPPILLIL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 10182) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: WI 10182) |
Enumeration Date | 2020-05-05 |
Last Update Date | 2025-05-12 |