Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207NS0135X | Procedural Dermatology | 1077 | WV |
NPI | 1508167867 |
---|---|
Provider Name | Tara J. Robinson |
First Address | Barboursville, WV 25504 |
Second Address | Barboursville, WV 25504 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2010 |
Last Update Date | 23/11/2015 |