| 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 |