| NPI | 1982178273 |
|---|---|
| Former Name | TARA GERMAINE ST. ROSE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner Women's Health (Licence: NY 421421) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner Women's Health (Licence: MD PENDING) |
| Enumeration Date | 2019-01-20 |
| Last Update Date | 2021-06-08 |