| NPI | 1023424645 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: LA 303233) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN PA0000003288) |
| Enumeration Date | 2014-07-02 |
| Last Update Date | 2020-07-16 |