| NPI | 1356509038 |
|---|---|
| Former Name | TARA MARIE BRENTS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME113202) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2021040905) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036133782) | |
| Enumeration Date | 2008-05-29 |
| Last Update Date | 2025-04-14 |