| NPI | 1033657218 |
|---|---|
| Former Name | TIFFANY MARIE LEASE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: CO APN.0992903-NP) |
| Enumeration Date | 2017-02-07 |
| Last Update Date | 2019-10-29 |