| NPI | 1336931146 |
|---|---|
| Former Name | TIJA JANEE' LAVINE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA 242716) |
| Additional Taxonomies | 163WN0300X Registered Nurse, Nephrology (Licence: LA RN152437) |
| Enumeration Date | 2025-05-19 |
| Last Update Date | 2025-08-11 |