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Individual
MISS FAFA TSIKATA
Active
Individual
MISS FAFA TSIKATA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
RT005186
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200005221
BOARD OF CERTIFICATION
—
01
—
RT005186
PENNSYLVANIA BOARD OF MEDICINE
PA
Enumeration date
05/16/2017
Last updated
05/16/2017
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