NPI | 1124325295 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN PA 2316) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: AR PA-429) |
Enumeration Date | 2011-02-24 |
Last Update Date | 2022-03-31 |