NPI | 1851655765 |
---|---|
Former Name | LEENA RACHEL PHILIP |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MB09680500) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OS017348) |
Enumeration Date | 2012-06-26 |
Last Update Date | 2016-10-26 |