| NPI | 1306968482 |
|---|---|
| Former Name | TARA LYNN CORKERY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: UT 10088016-1206) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NV PA1111) |
| 363A00000X Physician Assistant (Licence: MD C0003211) | |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2022-07-21 |