NPI | 1962939637 |
---|---|
Former Name | KUMBLA REETHU NAYAK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX S8471) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10059403) |
Enumeration Date | 2017-05-12 |
Last Update Date | 2020-10-09 |