NPI | 1700171972 |
---|---|
Former Name | TARA MICHELLE NEWCOMB |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: WV 27135) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC LL33653) |
Enumeration Date | 2011-06-15 |
Last Update Date | 2022-04-18 |