| NPI | 1164683835 |
|---|---|
| Former Name | TARA J BLY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: IA 39579) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IA R-8408) |
| Enumeration Date | 2008-06-24 |
| Last Update Date | 2020-07-30 |