| NPI | 1962938944 |
|---|---|
| Former Name | JACIENTA PAILY THEVERKATTU |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: NY 299731) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2022-11-21 |