| NPI | 1295160844 |
|---|---|
| Former Name | TARRYN BOLOGNANI |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NH 1385) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: VT 104.0098262) |
| Enumeration Date | 2013-09-13 |
| Last Update Date | 2018-08-03 |