| NPI | 1982005674 |
|---|---|
| Former Name | TAMIKA RENEE DICKENS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 2526) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 017971) |
| Enumeration Date | 2014-09-12 |
| Last Update Date | 2018-02-05 |