| NPI | 1255171559 |
|---|---|
| Former Name | TAMARA NICOLE GREEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: FL RN9293821) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11033853) |
| Enumeration Date | 2024-05-27 |
| Last Update Date | 2024-10-20 |