| NPI | 1013000728 |
|---|---|
| Former Name | TAMARA ANN VIRGILIO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00757100) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO 1619) |
| 363A00000X Physician Assistant (Licence: MD C03461) | |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2024-11-20 |