| NPI | 1629699616 |
|---|---|
| Former Name | TIFFANY ANN VIA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: IL 209.021088) |
| Enumeration Date | 2020-04-30 |
| Last Update Date | 2024-10-02 |