| NPI | 1184966368 |
|---|---|
| Former Name | TARA BITTNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WI 7250) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 363A00000X Physician Assistant (Licence: OR PA169296) | |
| Enumeration Date | 2013-03-26 |
| Last Update Date | 2023-04-20 |