| NPI | 1932685740 |
|---|---|
| Former Name | TARA POWERS BRANTLEY |
| 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 | 2025-10-17 |