| NPI | 1124443031 |
|---|---|
| Former Name | TANYA TREASA UTHUP |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209011189) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209011189041355741) |
| Enumeration Date | 2014-02-28 |
| Last Update Date | 2023-01-12 |