| NPI | 1891167946 |
|---|---|
| Former Name | TARA MARIE FAHRNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MT 9377) |
| Additional Taxonomies | 2251C2600X (Licence: MT PTP-PT-LIC-9377) |
| Enumeration Date | 2015-10-28 |
| Last Update Date | 2024-09-10 |