| NPI | 1750959920 |
|---|---|
| Former Name | TIFFANY AMBER HENRY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CT 11369) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 383244) |
| Enumeration Date | 2021-06-15 |
| Last Update Date | 2025-01-22 |