| NPI | 1871097238 |
|---|---|
| Former Name | TYAJEAN OLIVE MABEE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MT MED-PHYS-LIC-100286) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MT MED-RES-LIC-67462) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-03-21 |
| Last Update Date | 2021-08-11 |