NPI | 1154728442 |
---|---|
Former Name | TARA MILLER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP014167) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP014167) |
Enumeration Date | 2014-12-02 |
Last Update Date | 2020-06-16 |