| NPI | 1356515597 |
|---|---|
| Former Name | TIFFANY LYNN NEWTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IL 36-134855) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 2011-00207) |
| Enumeration Date | 2008-04-18 |
| Last Update Date | 2017-11-29 |