| NPI | 1639540685 |
|---|---|
| Former Name | TIFFANY STODDARD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 95004127) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CO 0991941) |
| Enumeration Date | 2015-10-16 |
| Last Update Date | 2016-08-24 |