NPI | 1851416622 |
---|---|
Former Name | TIFFANY A. GEAHIGAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-08285) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MA 1125) |
Enumeration Date | 2007-03-20 |
Last Update Date | 2021-05-06 |