| NPI | 1588385892 |
|---|---|
| Former Name | TIFFANY MARIE MARTINEZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 13573) |
| Enumeration Date | 2022-09-06 |
| Last Update Date | 2024-10-11 |