NPI | 1689893885 |
---|---|
Former Name | SUVY VATTASSERIL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME111386) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 243468) |
Enumeration Date | 2007-04-25 |
Last Update Date | 2018-08-15 |