| NPI | 1023534401 |
|---|---|
| Former Name | CANDACE DANIELLE MATHERLY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 3325) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2017-08-17 |
| Last Update Date | 2024-09-11 |