| NPI | 1316207079 |
|---|---|
| Former Name | JOSEPH ABANG TANYI |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171W00000X Contractor (Licence: DC 620439696) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: DC 620439696) |
| Enumeration Date | 2012-05-29 |
| Last Update Date | 2012-05-29 |