| NPI | 1841242278 |
|---|---|
| Former Name | TIFFANY L WOLF |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 3105) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110002318) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2016-09-12 |