| NPI | 1033303201 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 19701) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN PA1520) |
| Enumeration Date | 2007-08-30 |
| Last Update Date | 2015-03-30 |