| 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 |