| NPI | 1427226745 |
|---|---|
| Former Name | TAMMY LYN VENEMA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WI 64165) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 35.090820) |
| Enumeration Date | 2008-02-20 |
| Last Update Date | 2015-08-13 |