| NPI | 1104261361 |
|---|---|
| Former Name | MARTHA JANE TEPAS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: CT 63914) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: NH 19347) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207R00000X Internal Medicine (Licence: CT 63914) | |
| 207R00000X Internal Medicine (Licence: NH 19347) | |
| Enumeration Date | 2013-05-01 |
| Last Update Date | 2019-07-17 |