| NPI | 1164503108 |
|---|---|
| Former Name | TAMIKO L KOLKJEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 004550) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: MI 1601000462) |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2014-12-03 |