| NPI | 1265723522 |
|---|---|
| Former Name | TARA N. GIBNEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00447500) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: RI PA00591) |
| 363AS0400X Physician Assistant, Surgical (Licence: NY 014723) | |
| Enumeration Date | 2011-04-21 |
| Last Update Date | 2024-05-02 |