| NPI | 1255801809 |
|---|---|
| Former Name | TARA DANIELLE MARTINEZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: TN 220334) |
| Additional Taxonomies | 183700000X Pharmacy Technician (Licence: TN 53490) |
| Enumeration Date | 2018-11-27 |
| Last Update Date | 2018-11-27 |