| NPI | 1114902236 |
|---|---|
| Former Name | MARY JANET TYE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DC PA030929) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: GA LD002606) |
| 363A00000X Physician Assistant (Licence: VA 0110003424) | |
| Enumeration Date | 2005-12-13 |
| Last Update Date | 2014-03-27 |