| NPI | 1225055171 |
|---|---|
| Former Name | KACIE BETH TARTARO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 1726) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC RX1726) |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2020-12-09 |