| NPI | 1578573440 |
|---|---|
| Former Name | TYNNETTA DAWSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R153464) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MD R153464) |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2019-04-18 |