| NPI | 1952818403 |
|---|---|
| Professional Name | TAMYRA WALLACE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP135378) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN AP135378) |
| Enumeration Date | 2018-01-05 |
| Last Update Date | 2018-07-03 |