| NPI | 1720588742 |
|---|---|
| Former Name | VIJAYALAKSHMI MAMMAYIL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 402429) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 681075) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ 238344) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 238344) | |
| Enumeration Date | 2018-02-16 |
| Last Update Date | 2022-07-13 |