| NPI | 1851366454 |
|---|---|
| Former Name | JAYASHREE VENUGOPAL PURUSHOTHAMALU |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 065912) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101237911) |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2022-03-07 |