| NPI | 1861162414 |
|---|---|
| Former Name | STACY GEORGEKUTTY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP144895) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP144895) |
| Enumeration Date | 2021-09-15 |
| Last Update Date | 2022-12-06 |