NPI | 1760707822 |
---|---|
Former Name | ANITHA PONNAMMA JOHN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 714039) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX 714039) |
Enumeration Date | 2010-04-01 |
Last Update Date | 2012-06-29 |