NPI | 1700961141 |
---|---|
Former Name | TARA REXANNE HARDEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208600000X Surgery (Licence: FL ME121048) |
Additional Taxonomies | 174400000X Specialist (Licence: AL 28214) |
Enumeration Date | 2006-10-26 |
Last Update Date | 2021-07-07 |