NPI | 1205832565 |
---|---|
Former Name | TANYA DEUKMEDJIAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11006386) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH9229) |
Enumeration Date | 2005-06-22 |
Last Update Date | 2020-03-11 |