| NPI | 1982741542 |
|---|---|
| Former Name | TAMARA CHANETTE CARRINGTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: GA 5806) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: OK APA1596) |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2022-05-05 |