| NPI | 1265637953 |
|---|---|
| Former Name | TAMARA DENISE GLOVER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101245822) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WV 24251) |
| 207Q00000X Family Medicine (Licence: MD D0072391) | |
| Enumeration Date | 2007-06-20 |
| Last Update Date | 2021-03-31 |