NPI | 1952079931 |
---|---|
Former Name | TASHINA LOUISE MARTIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OR 202215622NP-PP) |
Additional Taxonomies | 163WD0400X Registered Nurse, Diabetes Educator (Licence: OR 200541447RN) |
Enumeration Date | 2021-09-02 |
Last Update Date | 2024-08-26 |