| NPI | 1033191663 |
|---|---|
| Other Name | TAMMY LYNN BERANEK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: WI 117 039) |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2007-07-08 |