| NPI | 1154346252 |
|---|---|
| Former Name | TARAH LEANNE JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR.0067875) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 4694) |
| 2083A0100X Preventive Medicine Aerospace Medicine (Licence: VA 0102201093) | |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2022-08-01 |