| NPI | 1083110597 |
|---|---|
| Former Name | TIFFANY JEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0101273658) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 238850) |
| 207Q00000X Family Medicine (Licence: VA 0101273658) | |
| 207Q00000X Family Medicine (Licence: WI 8378851) | |
| Enumeration Date | 2018-04-03 |
| Last Update Date | 2024-06-07 |