| NPI | 1215365226 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN PA0000004455) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.004900) |
| Enumeration Date | 2013-10-30 |
| Last Update Date | 2024-07-24 |