| NPI | 1356667265 |
|---|---|
| Former Name | TANYA LEIGH PUTNAL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 27890) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2010-04-16 |
| Last Update Date | 2017-05-02 |