| NPI | 1306207733 |
|---|---|
| Former Name | TIA-MONIQUE FAITH BLASH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 277.001548) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209014008) |
| Enumeration Date | 2016-03-12 |
| Last Update Date | 2021-10-22 |