NPI | 1194019398 |
---|---|
Former Name | TASHARA NATASHJA MARTIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: AZ 61785) |
Additional Taxonomies | 208000000X Pediatrics (Licence: SC LL33679) |
208000000X Pediatrics (Licence: FL ME119054) | |
Enumeration Date | 2011-06-06 |
Last Update Date | 2023-05-17 |