| NPI | 1154512374 |
|---|---|
| Former Name | TARA LEIGH STROM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601004211) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MI TT004211) |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2023-03-06 |