| NPI | 1750936274 |
|---|---|
| Former Name | TAMAR RAE WILMS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: NY F309284-01) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: CT 8894) |
| 363LP2300X Nurse Practitioner Primary Care (Licence: NY F309284-01) | |
| Enumeration Date | 2019-08-02 |
| Last Update Date | 2025-01-13 |