| 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 |