| NPI | 1023335106 |
|---|---|
| Former Name | TIFFANY DEANNA MAINES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TN MD0000051185) |
| Additional Taxonomies | 208600000X Surgery (Licence: SC LL32817) |
| Enumeration Date | 2010-04-28 |
| Last Update Date | 2015-10-05 |