| NPI | 1417192543 |
|---|---|
| Former Name | TARA SUZETTE WILLIAMS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0001137566) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 5876P) |
| Enumeration Date | 2008-12-03 |
| Last Update Date | 2023-08-10 |