Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175L00000X | Homeopath | 4071 | NV |
NPI | 1154759017 |
---|---|
Provider Name | Tiffany Tobin |
First Address | Las Vegas, NV 89130-3866 |
Second Address | Las Vegas, NV 89130-3866 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/10/2013 |
Last Update Date | 30/10/2013 |