NPI | 1578851325 |
---|---|
Former Name | TANDALAYA M HARRIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS R869243) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MS R869243) |
Enumeration Date | 2011-07-14 |
Last Update Date | 2011-08-10 |