| NPI | 1497918163 |
|---|---|
| Former Name | TARA LYNN WOMBOLD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP9182816) |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2010-07-01 |