| NPI | 1407183122 |
|---|---|
| Former Name | TARA IAQUINTO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00282200) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA053716) |
| Enumeration Date | 2009-11-17 |
| Last Update Date | 2022-10-18 |