| NPI | 1629574561 |
|---|---|
| Former Name | TIFFANY EVE DOTY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.017657) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9360950) |
| Enumeration Date | 2018-03-31 |
| Last Update Date | 2018-06-01 |