| NPI | 1891794871 |
|---|---|
| Former Name | TAMARA LEIGH CHEATHAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 200201556) |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: NC 200201556) |
| Enumeration Date | 2005-07-20 |
| Last Update Date | 2017-03-17 |