NPI | 1649422965 |
---|---|
Former Name | TIFFANY A LEE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A107137) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2008-10-17 |
Last Update Date | 2022-02-11 |