| NPI | 1174174536 |
|---|---|
| Former Name | IVANNA TIFFANY YU |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085007169) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IL 085007169) |
| Enumeration Date | 2019-09-26 |
| Last Update Date | 2025-02-06 |