| NPI | 1033120191 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110002869) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN PA1358) |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2017-02-06 |