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 |