| NPI | 1598733412 |
|---|---|
| Former Name | TAMARA DEE VAN DERAA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO 2002008193) |
| Additional Taxonomies | 207LA0401X Anesthesiology, Addiction Medicine (Licence: MO 2002008193) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MO 2002008193) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: MO 2002008193) | |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2012-02-10 |