| NPI | 1265723993 |
|---|---|
| Former Name | TIFFANY P. CROLL |
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA16657) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: LA PA.200422.RX) |
| Enumeration Date | 2011-04-28 |
| Last Update Date | 2023-10-31 |