NPI | 1902157571 |
---|---|
Former Name | TARA H HUBBART |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AR A003760) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TN 16972) |
363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 1084095) | |
Enumeration Date | 2012-09-24 |
Last Update Date | 2024-03-28 |