| NPI | 1720002322 |
|---|---|
| Former Name | TARA ANNE LAUREANO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 16302) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA NP16302) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2024-10-24 |