| NPI | 1679601413 |
|---|---|
| Former Name | TARA NICOLE BUCKLEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1710I1002X Military Health Care Provider, Independent Duty Corpsman |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| 247200000X | |
| 146N00000X Emergency Medical Technician, Basic | |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2024-01-20 |