| NPI | 1053560797 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0009504) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: TN PA0000001598) |
| Enumeration Date | 2008-09-18 |
| Last Update Date | 2024-08-21 |