| NPI | 1659740959 |
|---|---|
| Former Name | TARA SUZANNE CARRASCO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0222X Nurse Practitioner, Pediatrics, Critical Care (Licence: TX AP126855) |
| Enumeration Date | 2015-09-17 |
| Last Update Date | 2015-09-17 |