| NPI | 1063750719 | 
|---|---|
| Former Name | TAMRA DEE WARNER | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0006513) | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA11425) | 
| 363A00000X Physician Assistant (Licence: CA 22804) | |
| Enumeration Date | 2013-01-30 | 
| Last Update Date | 2022-01-16 |