| NPI | 1972886802 |
|---|---|
| Former Name | TIFFANY CRANE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: VA 0110004081) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 003372) |
| Enumeration Date | 2011-09-27 |
| Last Update Date | 2013-01-18 |