| NPI | 1255619854 |
|---|---|
| Former Name | TAMARA MARIE JETTE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: PA MD453089) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: PA MT200298) |
| 207T00000X Neurological Surgery (Licence: PA MD453089) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD453089) | |
| Enumeration Date | 2011-07-30 |
| Last Update Date | 2023-12-01 |