NPI | 1790925345 |
---|---|
Former Name | TIFFANY ELIZABETH GARNSEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WI 3064-23) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 013168) |
Enumeration Date | 2009-02-23 |
Last Update Date | 2022-07-21 |