| NPI | 1215908538 |
|---|---|
| Former Name | TAMMY CRACE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: IN 10001016A) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: KY PA483) |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2016-08-02 |