| NPI | 1710016050 |
|---|---|
| Former Name | TANNIA LYN HINES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA01209) |
| Enumeration Date | 2007-03-04 |
| Last Update Date | 2021-02-03 |