| NPI | 1518125343 |
|---|---|
| Former Name | TIFFANY JOSEPHINE TAUSALA COLEMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA MD60222843) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2008-05-29 |
| Last Update Date | 2014-08-14 |