| NPI | 1740291483 |
|---|---|
| Former Name | TAMYRA N BERRY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 2023-023) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WI 2023-023) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2020-05-15 |