| NPI | 1063772523 |
|---|---|
| Former Name | TARA ELIZABETH LOWELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VT 016.0086114) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NH 03881) |
| Enumeration Date | 2012-05-17 |
| Last Update Date | 2012-05-17 |