| NPI | 1619302247 |
|---|---|
| Former Name | TARA JILL MOSSHOLDER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WI 152814) |
| Enumeration Date | 2013-09-13 |
| Last Update Date | 2018-07-02 |