| NPI | 1295926244 |
|---|---|
| Former Name | TANEISHA A HAYDEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601004793) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MI 5601004793) |
| Enumeration Date | 2007-08-06 |
| Last Update Date | 2022-05-09 |