NPI | 1932685740 |
---|---|
Former Name | TARA POWERS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA A182566) |
Additional Taxonomies | 208600000X Surgery (Licence: CA A182566) |
Enumeration Date | 2018-07-15 |
Last Update Date | 2024-12-06 |