NPI | 1669642237 |
---|---|
Former Name | TAHIRAH A TYRELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME115083) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL ME115083) |
207Q00000X Family Medicine (Licence: NY 269460) | |
Enumeration Date | 2008-03-10 |
Last Update Date | 2024-04-13 |