| NPI | 1679247407 |
|---|---|
| Former Name | TARA ELIZABETH JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11014607) |
| Additional Taxonomies | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: FL 11014607) |
| Enumeration Date | 2021-08-04 |
| Last Update Date | 2021-08-31 |