| NPI | 1750656955 |
|---|---|
| Former Name | TARA NICOLE BANASZEK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: MO 2016016743) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MO 2016016743) |
| Enumeration Date | 2012-03-20 |
| Last Update Date | 2024-12-02 |