| NPI | 1346676798 |
|---|---|
| Former Name | MIRANDA TAMOK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C07973) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0006631) |
| Enumeration Date | 2013-09-17 |
| Last Update Date | 2024-09-20 |