| NPI | 1760403141 |
|---|---|
| Former Name | TAMI BROADWATER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024165943) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: VA 0024165943) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2015-07-27 |