| NPI | 1548202658 |
|---|---|
| Former Name | AMY MICHELE TANNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD204185) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO 0052486) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2021-08-20 |