NPI | 1588086185 |
---|---|
Former Name | ALLISON DAWN TIFFANY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-04767) |
Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: NV PA1787) |
Enumeration Date | 2014-01-16 |
Last Update Date | 2024-02-09 |