| NPI | 1962885368 |
|---|---|
| Former Name | DEEPTHI SHETTY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: CT 61409) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2015-07-02 |
| Last Update Date | 2018-07-19 |