NPI | 1386264182 |
---|---|
Former Name | TAVISTY KAY TARKENTON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX T6728) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2020-04-21 |
Last Update Date | 2023-02-23 |