NPI | 1265715254 |
---|---|
Former Name | TIA D THOMAS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA AP06652) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 807424) |
Enumeration Date | 2011-09-26 |
Last Update Date | 2023-07-06 |