| NPI | 1326282138 |
|---|---|
| Former Name | TARA LYNN GOSS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1710I1003X Military Health Care Provider, Independent Duty Medical Technicians |
| Enumeration Date | 2009-04-23 |
| Last Update Date | 2009-11-30 |