| NPI | 1184133712 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: TN PA0003396) |
| Enumeration Date | 2017-09-27 |
| Last Update Date | 2023-06-15 |