NPI | 1063996189 |
---|---|
Former Name | TIFFANY ATIR FIELDS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MI 4704252951) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704252951NSA18974) |
Enumeration Date | 2018-09-25 |
Last Update Date | 2022-11-17 |