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1114683067
CANISIA BONGFEN TATAH
TULSA, OK
NPI
1114683067
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2021-11-15
Last Update Date
2021-11-15
Business Address
CANISIA BONGFEN TATAH
5209 S HARVARD AVE APT C
TULSA, OK 74135-3546
Phone number: 405-875-2075
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Mailing Address
CANISIA BONGFEN TATAH
5209 S HARVARD AVE APT C
TULSA, OK 74135-3546
Phone number:
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