| NPI | 1508909896 |
|---|---|
| Former Name | SUMMER RENEE TANGEMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO 2376) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO 2376) |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2016-12-16 |