| NPI | 1891367165 |
|---|---|
| Former Name | TIFFANY YVONNE FERGUSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) (Licence: VA t61755910) |
| Enumeration Date | 2021-07-15 |
| Last Update Date | 2021-07-15 |