| NPI | 1689940140 |
|---|---|
| Former Name | SISSY CHACKO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX Ap127288) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 337023) |
| Enumeration Date | 2012-03-29 |
| Last Update Date | 2021-12-28 |