| NPI | 1225528490 |
|---|---|
| Former Name | TASHA NICOLE SPARKS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: IN 11020111A) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2018-05-14 |
| Last Update Date | 2018-06-14 |