Tara is founder & CEO of Rupa Health, an integrative health tech company that aims to make root cause medicine the standard of care. Their first product, Rupa Labs, is a lab ordering portal for telemedicine providers that turns 15 hours of weekly physician admin work into 15 minutes.

Tara joins me today to discuss how she bridged her worlds to create Rupa. She shares with us about the early days and the low tech way that her and her co-founder would get the work done at first. We learn about the scale and the future of her company. Tara shares her philosophy of interviewing and the importance of growing a great team.

“If you can just be really kind and make everybody be genuinely interested in the people you're talking to, and care about them and their life and what their wants and needs are. So if you're a founder, and you're meeting an investor, take time to learn about their life and what you know what they've done. And that will go a long way. And people forget about that.”

- Tara Viswanathan

Today on Startups for Good we cover:

  • Weaving conventional medicine with other styles
  • How it feels when you reach market fit
  • Selling your product when it isn’t quite ready
  • Fundraising strategy
  • The importance of momentum

Connect with Tara on her website, LinkedIn, Facebook and Instagram.

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Transcript

Miles

Welcome to startups for good. Thanks for coming on.

Tara

Thanks, Miles Great to be here.

Miles

I'm excited to dive into your story of Rupa. And before, why don't we start with how did you decide to become a founder?

Tara

Oh my gosh, Miles. I wish I had a really good answer for this. But I don't I think it's something that I've always known. I was even I'm reading this book called The Artists Way. I don't know if you've heard of it. But it's, it's kind of a classic at this point. But, it essentially talks about the artists journey, and, you know, creativity and things like that. And one of the things that's had me do is kind of a workbook is think about my childhood. And the question I was reflecting on yesterday, actually, was, what was it that I love doing as a kid. And the only thing I could come up with was creating, I was always just making things. So whether it was like clothing for my dolls, or you know, making and selling duct tape purses, or whatever it was, is always creating. So what made me decide to be a founder, I have no idea. I think it's probably this innate urge to create. And then also, on the other end of that is probably a fear of being constrained in any way.

Miles

That's fascinating. Also, learning a little bit about your background, it seems like you've bridged worlds, from math and are to others. Is that part of it as well?

Tara

Yeah, I absolutely think so.  I feel like I've always straddled multiple different worlds is, as you put it, is probably good way to think about it. And, you know, growing up as an Indian American in West Texas is one of them. And then, you know, studying finance at Wharton, while also learning art, you know, is another one. And I think it's just because I'm, I'm curious, I'm incredibly curious. And I, my brain works the best. When I am exploring, and I'm putting things together, I've learned that I'm definitely a systems thinker. I'm not, I'm not great at just linear thinking, I'm much better at bringing things from different industries. And you know, that definitely gets us into Rupa. Right, where we're talking about bridging the gap between maybe like alternative or Western or lifestyle as an alternative or holistic or lifestyle medicine, along with conventional medicine as we see it today.

Miles

Yeah, so how do you weave that together? And Rupa?

Tara

Yeah, great question. Um, well, I guess, the basis of Rupa is, how do we create, you know, allow for root cause medicine, which is understanding the root cause of a person's illness rather than slapping on band aids for the symptoms? How do we actually make that the standard of care, versus what it seems to be today, which is a healthcare system that is guided by just masking the symptoms or band aiding the symptoms with pharmaceuticals and things like that? How do we actually achieve true health, from a root cause perspective, and, and what we're seeing is actually that it's already being done. So we're seeing these incredible physicians from Stanford and these highly reputable hospitals and institutions, starting to weave in more holistic methods. So things like nutrition and lifestyle and diet and exercise and all of that. And so it's just bridging these two worlds in a way where one's not right and one's not wrong, but it's how do we utilize the best from both?

Miles

And what's your first product?

Tara

So our first product is the lab portal. So what we're doing is we're taking something that our physicians are already doing, which is utilizing specialty lab tests, such as, you know, DNA testing, microbiome testing, advanced hormone testing things that your traditional Western doctor isn't going to order for you. And, you know, and we're making that process super simple for our practitioners. So what we do is we're almost like a marketplace for these new kind of specialty labs.

Miles

And why don't quote unquote Western doctors order these labs.

Tara

That's a great question. They're starting to, um, but it's because they haven't been trained to do so. Right. So there's, it's funny because we think about it, you know, we've gotten to a place where maybe this is how humanity has always been. And this is me getting into, like my philosophical side. But we're getting to a place where we believe things like we know everything, right? I think like our society believes, like, we know everything, or science can solve everything. But in fact, there's a lot we don't know, especially about humans and our health and our world. And we forget that science starts with a hypothesis. And then people testing that hypothesis. And I think it's nuts to think that suddenly we've, you know, we find ourselves in this world where testing hypotheses and asking questions is kind of no longer. Okay. And, and so, when you ask, Why don't Western doctors utilize this testing? It's because I think we're still in the, you know, it's in the post hypothesis, but pre math acceptance phase. And if you think about it, doctors are getting educated when they're, you know, 22 to 26. And then they're not going back to medical school again. And so even though they're doing continuing education, the core is of the core of their learning is of the medical knowledge that they learned during med school. And if you as you can imagine, the tremendous advancements we've done in genetics, in microbiome research and things like that most of the doctors today did not have that when they were going through medical school. And I think that that's part of what is going on.

Miles

And this has been an incredible demand, and the growth is really impressive. It attracted me as an investor, top tier venture capitalists. How did you come upon this as an opportunity?

Tara

Oh, yeah, no, I think it's, I actually think that it's been a lifelong journey. And it's been a quest for how do I feel alive in every moment, I think, as a kid, I was really drawn to feeling joyful and feeling alive. I actually, you know, I did cancer research in high school, and studied genetics in high school. But I actually lost that when I went to college. And I mentioned, I studied finance at Wharton. It's really funny, because, you know, I say that I, I studied finance, but what I really learned was burnout. And so it's like, that's where I realized that there's, there's so much more to health than just looking good, or, you know, or surviving. And it was my journey to figure that out. And so that's what I came over to the west coast to do. I ended up studying product design for better health at Stanford, it was something I made up, I don't think that you can go look that up to they were very generous. And let me figure that out. Or let me do that. And it was kind of one thing led to another I mean, part of it was like right place, right time I got to Stanford at a time where they I think that was the first year that they were having all of their medical residents take a meditation course. And I got to, I got to do that with them. I studied nutrition there, I got to practice like life coaching for grad students. And, and what happened was, there was this massive movement towards wellness and holistic health. And I got to work at some pretty incredible companies, you know, that we're building for this kind of new wave of medicine. And ultimately, the thing that tipped me over the edge was when my mom got sick, and I'm not a doctor, but I was able to help her with the knowledge that I gained. And my dad, who is a, you know, traditional Western medicine doctor was not able to help her and had no tools to help her. And so that was really the turning point. For me.

Miles

That's powerful. Share with us a little bit about the journey of Rupa and the scale that you reached now.

Tara

Yeah, the the journey of Rupa. Lots of learnings and lots of ups and downs, I think the thing that drove us to and there there were so many moments when we we could have and I think it made logical sense to quit and go in a different direction. And the reason that we didn't is because we had utter belief in this market. It is by this market, I mean, the demand for better health treatment for especially for chronically ill patients, and what we're seeing amongst this, I guess, this like epidemic in the US of obesity and diabetes, and you know, metabolic syndrome and all of that, but then also mental health and kind of issues that are plaguing people who are, I don't know I think about them as like walking around as like hidden chronic illness people so a lot of my friends who are high performers and high achievers suffering and not feeling super well, those people as well. And so I think it's this belief that there needs to be a better way that's driven this. And but our journey was a lot of twists and turns. I mean, we started out as a marketplace for integrative practitioners. So a marketplace for acupuncturist, naturopathic doctors, nutritionists, people like that. We learned, you know, maybe a little bit too slow, like, it always feels like we learned too slowly. But enough, in hindsight, it was a little it was quick, that that marketplace doesn't make sense. We then shifted into building a full stack clinic. So it was a virtual Care Clinic. For integrative holistic practitioners, it was almost like a Shopify experience. And that's where we discovered the problem of lab testing. And I think, through this journey, I'd been at enough startups that never found that product market fit, or that never found that, you know, 10 x better thing that people are just craving and demanding to know that we needed to find it. And so for us, it was the quest of, yeah, we know, this is a growing market, but what is the tool that we can latch ourselves on to that we can that we can then grow from there? And that's how we came up with labs?

Miles

And what does that product market fit feel? Like?

Tara

Oh, totally different. It's like, it's kind of like, how I think about finding your life partner, right? If you have to ask like, you know, am I in love with this person? Is this my person, it's probably not your person. And so like, similarly, we probably recommend, if you have to ask if you feel like Do we have product market fit? You probably don't have it. I mean, it's kind of this overwhelming experience, where I mean, we the first version of this had nothing, it was a fake front end experience, where practitioners could go order lab tests. And then what would happen is my co founder and I were sitting on our couch, the company was just us at that point. And we would wait until someone would place an order. And then placing an order meant that Rosa and I got an email that said, this person wants this test to this patient. And we would then immediately, you know, ask each other, okay, are you going to do this one? Or am I going to do this one, we go create a PayPal invoice. We call up the lab place to order manually, and we just like send it all out. And we created a Google Doc with instructions on how to take the test. And that was it. And people were coming back to that, you know, week over week. And so that's when we realized, and they were sharing it with their friends. I think that's one of the biggest keys is people sharing it organically with their friends.

Miles

Yeah, we had Tiffany, on the show, who's founder and CEO of Remix, she talks about her product market fit situation, and really how powerful it can be when people just keep asking for it over and over again. So it's a wonderful feeling, I'm sure.

Tara

Yeah. And we started getting people started writing about us. I mean, I think a month after we launched, and we had no splashy launch week to date, have not done any kind of press or PR or anything like that. And this was about a year ago. And when we released the product, I mean, it was to three practitioners in the Bay Area. And within a few weeks, I think it was like three weeks, we had, I had the attention of two of the biggest players in our space, cold emailing me asking to meet up. And so it was just it just spread. And I think that the only thing is I think people are very forgiving of maybe an imperfect experience if you have product market fit.

Miles

So you're saying if they really need the problem solved, they'll take a half baked solution.

Tara

Yeah, yeah. And the goal is not to have to keep them out of exclusion. But I mean, it's kind of like comical, right? I, we still don't have a way since a year later, and 1000s of patients later. And we still don't have a way for a doctor to change their email address in this product, or edit that. Like it's just like, there's so many things that are missing, but they're still using it.

Miles

And how many people are using it.

Tara

And we we have practitioners in all across the US are legally not allowed to be in a couple states for billing purposes. But we have practitioners across the US using us hundreds of them we have in 1000s of patients. And we actually very quickly grew to from prototype to like, multi million annualized GMV in just a few months, which sounds crazy Miles but I think the thing that people are missing is that it was you know, two years in the making for this company and maybe eight years in the making of my understanding of this industry. So it was by no means an overnight success.

Miles

And how did you manage that scaling? So when you had that incredible demand popping up for this new product, it's the two of you sitting on the couch. What do you do?

Tara

Um, well, and then COVID hit, right.

Miles

Well, yeah,

Tara

No idea what was gonna happen, no idea. And what ended up happening was our market serves chronically ill patients and chronically ill patients are still going to go see their doctor. And so we weren't really affected. But we didn't know that at the beginning. And what we did was just, you know, we just kind of, as soon as we were out of capacity, we just brought on another person. I mean, it was, like, if you can imagine this is mid January of last year is when we released the product, February, very quickly, a couple of weeks, and we realized we were maybe hitting product market fit. And just fine. Still, only a handful of people were using it, but they were telling their friends. And we were just trying to work out the kinks. And then COVID hit. And what happened was, our labs all started getting worried. And they I ended up, I didn't know what was gonna happen to our industry. And so what I did was I just called up all of our lab reps to see if they had any insight into what was going to happen. And so I just, I mean, one thing people don't realize is like, you can people don't have to give you answers. But if you ask, they might give you answers. And so I you know, a lot of people are like wait, you called your lab companies to ask for their proprietary data. And like, yeah, if they, if they gave it to me, great. So So I called them our lab reps. And they actually shared a ton of information about how they saw the industry going what they thought was gonna happen. And it turned out that they ended up laying off a good chunk of their staff. And so one of the women at one of our labs was, had been the most incredible sales rep that I'd worked with, to the point where she knew this industry inside and out. And I had called her for sales advice. And she was going to give me a sales lesson. And I mean, she's, you know, 20, I want to I want to say like she was 22, right out of college, but just that like, hustler personality, who is who is absolutely incredible. And then COVID hit and she messaged me, and she's like, Hey, I'm sorry, I can't make our meeting I got, you know, I no longer work at this company. And that I called her maybe five minutes later, and I said, Okay, how would you like to come work for us, and just hired her on the spot. And now she's managing a team of of like six people and do incredible things and how we grew and how we scaled was literally that it was identifying people who will just go above and beyond and do amazing things and move mountains and then hiring them immediately.

Miles

You've been doing a lot of interviewing recently. How do you like to do it?

Tara

I love interviewing, I think it's so fun getting to meet people. And building a team is absolutely one of the most rewarding parts of this. I think that, yes, Rupa is my calling in so many ways. And the type of business that we're building and the industry we're building it in, is personally very fulfilling for me. But then there's also this other component of just building a business and building a team that I absolutely love. And so we talked about this a little bit. But one thing that's always driven me is this idea of living one life, where there really is not boundaries between work, and life and home and all of that. And I know that can be controversial now, especially as people talk about making sure that you do have boundaries between these different things. But I actually think that there's a better flow state for me personally, and one, which I think about as I think about growing our team, which is this fluidity between different aspects of life and feeling like your work is providing support for your personal life and vice versa. And how do we make all these puzzle pieces fit together? And for me, that's what recruiting is. It's building a team that can support that kind of culture and make amazing things happen. And so that has been truly like one of the most enjoyable parts of this whole thing.

Miles

So you're saying that candidates get to know you personally, before joining the company?

Tara

Oh, yeah, absolutely. I, uh, I mean, we just hired someone last week, and I, you know, weird times and COVID and I had him over and cooked and like, barbecued for him outside last Friday night. So that that's definitely part of it.

Miles

Yeah. One of the things I think it's important in hiring is giving people a realistic understanding of the risks and potential downsides. I remember when we would interview for people at my first startup, I would always give them a spiel that we could go out of business. And it may not work. And I wanted people to hear it from me, not just the vision and the excitement, but also real acknowledgement of the downside.

Tara

Exactly. Actually, that's such a great point. Two of the things that I say upfront in any interview is, I don't sell people on startups. And I don't sell people on the type of like medicine that we are, are building for and what what our vision is, because I think that if people aren't internally motivated to come for those reasons, it's only a ticking time bomb if I try to convince them of that, and then they come on board later. So my goal in that first call is to just share information and not and listen to the person on the other end, sharing information to see if it's a mutual fit. And I think startup that is like one of the most important things like is this person really ready to join an early stage startup?

I'd be curious to get your opinion on vaporware and selling when your product isn't fully ready.

It's a great question. Like to customers or two employees or both?

Miles

I was actually shifting gears now and thinking more customer side.

Tara

Customer side. Great question. I think that it really depends on the market, the industry that all of that in the level to which you're doing vaporware. So for example, before we actually had Rupa built out, we, there was this big cut, we had the idea for the lab platform. And there was this big annual conference December of 2019. And remember, we released this product like mid January 2020. So maybe a month before, we were not going to have the product ready. We just had this idea. And so Rosa and I were thinking, you know, we also didn't have any money. It's not like we had millions of dollars in the bank. And we can easily fly to Vegas and go to a conference. We've never done anything like that before. But we thought, let's just go see what happens if we meet people there. And what we did is we created a we like bought iPads at Best Buy, and that we were planning on returning if we didn't need them anymore. And we created like a demo that was not working. But it was just a demo video. And we created business cards, and we did the whole thing we'd sold vaporware, but now I'm thinking about it. We definitely did this. And we went to the conference. And it was hilarious, because everybody was staying at the Venetian like $250 a night, they bought multiple $1,000 tickets, and Rosa and I stayed at circus circus for 20 bucks a night and walked over down the strip every morning and bought like we somehow fandangled like students when we did the whole thing, right. And that conference, like if we hadn't gone and sold the vision of what we were doing, we would not have the labs on board that we needed, or even the initial insights that we needed to get off the ground. So as I'm in answer to your question, I actually think it's really important. But I think that there's so much context in there. Like I don't think that we would have ever done something that felt unethical to us at that point. Um, and so in terms of, you know, taking people's money or promising things that we couldn't fulfill or whatnot, there's a fine line, but to some extent, I think it is a founders role to make something out of nothing, and to know how to sequence that. And so yeah, what do you think?

Miles

I agree with you that it's often a necessary part of building a company is being able to sell a vision ahead of what has already been built. I think there are red lines in terms of when you talk about facts, if someone says, Well, is it built yet? You answer honestly, right? If you're taking someone's money and not being clear about your ability to deliver, that can be a problem. But showing someone a demo and saying this is what we're working on. This is what we're building and getting feedback. I think that's the nature of product development and the nature of entrepreneurship.

Tara

Yeah, absolutely. Absolutely. And I think it's, it's definitely a fine line because one of the best pieces of advice I've gotten from one of our advisors who I respect enormously was he said, Tara, in any negotiation or sale, determine what you want to tell the other person and then go make that a reality before you go tell them I love it. Isn't that isn't that amazing? feedback is like So for example, in the way he was saying, if you need to have a board of advisors in your negotiation that you can blame things on, say, I need to go check my board of advisors, go actually make that board of advisors. Because ultimately, at the end of the day, whatever you say will be exposed. And so you need to be able to stand by what you say.

Miles

Yeah, when you're getting into negotiation, and things like that, I really don't think that negotiating requires you, to dissemble to lie. I think a great book that talks about how you can be really transparent, and still negotiate really well is called Getting More He's a Penn professor, I think, who wrote that book,

Unknown Speaker

Which one was it? I actually TA negotiations

Miles

I'm embarrassed enough to say, I can't remember his name now.

Tara

Richard Shell, or was it Blunt? If it was Blunt, I actually was his TA.

Miles

Oh, really?

Tara

That totally changed my life when I realized that everything in life is a negotiation. And you don't have to be exactly as you're saying, like unethical power player, any of that.

Miles

Well, I'm looking it up now. It's Diamond, Stewart Diamond.

Tara

Okay. I don't know him. But that's amazing.

Miles

Hello, I highly recommend that book. I've read a bunch of books on negotiation. And I also subscribe to Sam Harris's philosophy online, which is basically almost never do it. I mean, you have to have extreme extreme cases of threatened violence before it really makes sense. So maybe a little far afield. But you were talking about the concept of making it true before you enter negotiation? I wonder if you apply that to your fundraising strategy?

Tara

Yes, I guess this goes back into my like, larger life philosophy of, I think the most important thing to invest in is your is your belief about yourself, and your confidence in yourself. And I think anytime you stretch the truth, or you tell, you know, a white lie, whatever it is, you are undermining your belief in yourself and your confidence in yourself. And ultimately, that is the stuff that will catch you and will make you not succeed. So when it comes to fundraising, yeah, like I I mean, I think that's, especially in that super small investor community. And I only, like I only stick to the to the strictest like, truth. Um, however, I

Miles

just mean, in truth, but I was talking also about the idea of building what you want to be selling? Oh,

Tara

yeah, of course. Of course, you got you got to do that. I think that, I think that's honestly, Miles just like doing a startup. You whatever you want to go say to your customers, you need to make sure that that is true. Whatever we want to go say out to investors, hey, our retention rate is XYZ. Okay? If it's not there, we need to go get it there. Or we need to figure out why it's not there. Or we need to go find the metrics that we do want to share? Absolutely.

Miles

Do you have any other advice for founders on fundraising?

Tara

Oh, my gosh, I have so much advice. I think that I got really lucky by being surrounded by some, like incredible fundraisers and people who've given me advice. I think it's particularly difficult for women, because I tend to think that women give each other bad advice around fundraising. And I hate saying that, but I do think it's true, where the advice I got from women versus men was vastly different around fundraising. And by the way, if any women are listening to this, I'm happy to talk or guide or do whatever I can, um, when it comes to fundraising, anything about a startup, it literally is just about momentum? And how do you create momentum? And how, you know, how do you play into human behavior?

Miles

Say more.

Tara

So, I also think that at the early stages is very different than at later stages. At early stages, you are primarily selling yourself and you're sharing stories. And so and this is true for any kind of marketing, right? For any kind of marketing, what you're trying to do is you're trying to take the person who is in front of you likely needs to go justify the decision they're about to make with everybody else in their team. So when you think about like a fundraise, it's maybe you're talking to a partner and they need to go convince the rest of their team that you're worth investing. And so they're constantly looking for those tidbits and checkmarks that they can go back and share. Similarly, if you're trying to hire a candidate, that candidate is looking for things They can take back and go tell their friends and family who care about them saying like, I know that you guys think I should go do something more safe and stable. But I think this is the best decision because of x, y, z. Here are the reasons why. And basically, your job as the founder is to create and list out those reasons very clearly for your audience that they can go back. So that can be I think, people, people don't focus enough on personal stories that are catchy in their fundraise. So for example, if I'm going to do a fundraiser, I think too many people fall into the trap of, here's our problem, here's our market, here's our vision, here's our team. And here's what we're raising, right? And here's our attraction, maybe what and that's, that's what you'll mostly get. What is missing from that is this, the key little nugget of wisdom that says more about who you are, and how you operate than, than anything in that deck. So for example, something like one of my friends who's actually who actually I'm going to introduce you to because he's about to start fundraising. One of the things that he did He's incredible at is reaching out to people who you think that he would never be able to get in contact with and sell them on his business, I think he reached out to a former CEO of Twitter, on Twitter through a DM, told him about what he was doing. And now the former CEO is like, mentoring him on how to you know how to do a fundraiser. And it's like little stories like that, that you want to share. And obviously not that one to two investors, but with the person you're selling, so that they can go share that with other people, because that's what people want to talk about. And, and like, for us, those were little stories of people showing actual screenshots of what people had said about our product in response to a cold email. And like they said, like you were the answer to my prayers, and then people remember that, and then they go share that with our entire team. That's me rambling. But does that make sense?

Miles

Yeah, I think what you're saying is, remember that people have a hidden dimension, they have a set of people who may be explicit approval, you know, have approval override rights, or implicitly, they're looking for their approval, and arm, the person you're talking to, to be able to sell to their audience, not just selling the person you're talking to, but give them the stories that will be memorable enough that they can pass on to their audience.

Tara

Yes. And then one other thing I think is really critical that people just forget, is to be nice. People like people who like them, right? And so if you can just be really kind and make everybody be genuinely interested in the people you're talking to, and care about them and their life and what their wants and needs are. So if you're a founder, and you're meeting an investor, take time to learn about their life and what you know what they've done. And that will go a long way. And people forget about that.

Miles

Good advice. So, as you were making these fundraising pitches, I'm sure you had to talk about the long term vision or as you've been hiring people, you've talked about the long term vision of Rupa, what is it? Things go? Well, what's it like?

Tara

Yeah, oh my gosh. The sky's the limit. Like I have visions of Rupa actually, like creating a brand new medical journal that is focused on this, like root cause perspective, and how do we incorporate all of these other dimensions of health that is not just going to the going to the doctor and looks like today? I believe that Rupa will be the meta brain layer for primary care and beyond in terms of this person is coming to me, how do I know what's going on with them when taken taking into account their sleep, their, you know, their diet, their nutrition, all of that, their their DNA, all of that. And so the way we think about it is Rupa allows for personalized medicine to become a reality in a way that you're going to the doctor, you do not like the person on the other end already knows what's going on with you and can diagnose effectively, it's kind of just what we all want. Um, but yeah, it's on. It's just as simple as what I what I had mentioned earlier around ruba is eliciting root cause medicine as the standard of care for the future.

Miles

Awesome. Any other advice for aspiring founders?

Tara

Oh, man. It's a ride, do it. It'll be the best ride of your life. I think that one of the one of the things that has been so fun to see not only in me, but our team is the level of growth and, like personal growth that every single person goes through. Because an hour feels like a day a day feels like a week, a week feels like a month a month feels like a year. And you're growing that fast. And it's been it's been so rewarding to see that in myself and see on our team so I just I'm so excited for people who go on this journey and are are scared and do it anyway. And are the you know, men and women in the arena?

Miles

Scared and do it anyway. That's the definition of courage. I love where can people follow you online?

Tara

I'm anywhere Instagram, Facebook, LinkedIn. I'm pretty. I'm awful at email, but I'm pretty accessible. And I love talking to other founders. So I'm definitely and I'm always happy to be helpful if possible. But I'm all the socials and then I have a personal website that needs to be updated.

Miles

Well, thank you so much for coming on.

Tara

Thanks, Miles. Good to talk to you.