NPI | 1821289315 |
---|---|
Former Name | PRIYA ANN PULLUKAT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301508990) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036-121103) |
Enumeration Date | 2007-08-08 |
Last Update Date | 2024-02-22 |