| NPI | 1003484072 |
|---|---|
| Former Name | HEATHER TISDALE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX V7994) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX BP10077045) |
| Enumeration Date | 2021-06-15 |
| Last Update Date | 2025-05-06 |