| NPI | 1285811620 |
|---|---|
| Former Name | TANYA GRISSELL LOPEZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2008-01-29 |
| Last Update Date | 2019-09-27 |