| NPI | 1447299300 |
|---|---|
| Former Name | TIFFANY BERKSHIRE FRAZER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL OS7645) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL OS7645) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2013-02-28 |