| NPI | 1306035605 |
|---|---|
| Former Name | TINA MARIE TAYLOR |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: OH RN 269455) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH 025623) |
| Enumeration Date | 2007-10-23 |
| Last Update Date | 2020-01-24 |