| NPI | 1114687829 | 
|---|---|
| Former Name | TAMMY MICHAELA SIMON | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: VA 0024182778)  | 
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: VA 0024182778)  | 
| Enumeration Date | 2021-12-21 | 
| Last Update Date | 2024-08-30 |